Migraine and sinus headaches

Sinus inflammation can seriously worsen migraine attacks according to a recent presentation by Dr. V. Martin and his colleagues made at the 54th Annual Scientific Meeting of the American Headache Society in Los Angeles. Migraines are often mistaken for sinus headaches because pain of migraine is often felt in the area of sinuses and many migraine attacks are accompanied by a clear nasal discharge. These patients will naturally first see an ENT specialist and often undergo treatment with antibiotics and even surgery before the diagnosis of migraine is considered. However, sinus inflammation, both allergic and non-allergic in nature, can coexist and worsen migraines and increase disability caused by migraine according to these new findings. Many neurologists will often dismiss the diagnosis of sinus headaches and proceed with treating only migraine symptoms. On the other hand, many patients and ENT doctors will focus solely on treating sinus disease and ignore the possibility of migraines. As a neurologist, I also tend to be biased in the direction of migraine headaches, however, but now will try to always consider the possible contribution of sinus disease as an aggravating factor. This study may explain why some of my patients with definite migraines will often report at least some improvement from sinus or allergy medications.

  1. Dr. Mauskop says: 09/06/20128:04 am

    Sinus disease should not interfere with the efficacy of nasal sprays, such as Zomig NS, Imitrex NS, and Migranal, however just plain nasal congestion might. When the nasal mucosa is inflamed and swollen it may not absorb the medication as well. Runny nose may also cause the medicine drip out with the nasal discharge.

  2. NY71 says: 09/06/20121:18 am

    Is there any merit to an Intranasal spray in a migraine sufferer who also has concurrent sinus disease?

    I do experience, as you mention, sinus congestion during a HA attack, however I had not considered generalized inflammation of the sinuses being a contributing factor to migraine.

  3. Dr. Mauskop says: 07/08/20128:45 pm

    Sugar is a common migraine trigger since many migraine sufferers also have reactive hypoglycemia – their bodies produce too much insulin when digesting meals high in carbohydrates. This leads to an excessive drop of the blood sugar level or hypoglycemia, which triggers a headache. Niacin has never been tested in rigorous scientific studies as a treatment for migraines, but many people report that it has helped them. As far as open heart surgery relieving migraines, it is more likely that the blood thinner given after open heart surgery is responsible for the improvement. Improved blood flow to the brain is also a possible cause.

  4. W. F. Miedecke says: 07/08/201210:40 am

    I have had migraine headaches since i was 16, they used to temporarily blind me, and I could not talk and make sense. They would last up to 4 days, gradually getting better. In 2009 I gave up sugar and found that I no longer had migraine headaches, so sugar was doing it for me.
    While talking to a woman running a healthfood store, she told me that using Niacin, non-flush, 500 mg, would stop my migraines, she was right, when I felt a migriane coming on, I took the Niacin, and after 20 minutes, the headache stopped cold. I am now 74 years old. Eleven weeks ago I had open heart surgery to replace a defective heart valve, since then I have had no headaches of anykind, I still get the migraine aura, but it never materializes to a migraine.
    I used to get sinus headaches, they have stopped also. BM74

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