Migraines Misdiagnosed as Sinus Headaches

Summary
Figures from a study called the American Migraine Study II have shown that nearly 28 million people in the United States suffer from migraine headaches. Many other patients with migraines are not included in the count because they are misdiagnosed as having sinus headache. This study attempted to clarify the diagnosis of sinus headache versus migraine. Results showed that the “majority of those with self-diagnosed sinus headaches have migraines or probable migraines.” The authors alert clinicians to be aware of these findings to make a correct diagnosis of migraine.

Introduction
Studies have shown that migraine affects nearly 28 million Americans; 18 percent of American women and 6 percent of American men. It is associated with severe headaches that incapacitate the person. These severe symptoms are seen in nearly 80 percent of sufferers. Migraines also damage the social life and work life of the person. However, studies have shown that fewer than half of migraine sufferers are actually diagnosed with the condition and less than 20 percent of patients receive medication to control the attacks. One common reason for this discrepancy is the incorrect diagnosis of the condition, with migraine patients being mistakenly diagnosed as suffering from sinus headaches. This study was undertaken to identify the common confusion that exist between the two conditions, and to enable physicians to diagnose migraine correctly.

Methodology
* The study involved 100 adults who thought they were suffering from sinus headaches.
* All the patients were assessed using standard criteria and guidelines. This was done to see if they were suffering from migraines instead.
* Questionnaires were also given to the participants to assess the level of disability that their headaches caused. They were asked about the effectiveness of the medications that they were taking to relieve headaches.
* Each participant was also asked if they had other symptoms like red or watering eyes, runny or blocked nose, and reddening face and ears.

Results
* About 63 percent of the participants actually had migraines and 23 percent had probable migraine, but they had been wrongly diagnosed as suffering from sinus headaches. Common reasons for wrong diagnosis were confusing triggers and associated symptoms of the headaches as perceived by the patients and reported to physicians.
* Common triggers for the migraine attacks were climate changes (83 percent), seasonal variations (73 percent), allergy-inducing material exposure (62 percent), and altitude changes (38 percent).
* Nose blockage was seen most commonly with the headaches (56 percent) followed by swelling of the eyes (37 percent), running of the nose (25 percent), redness of eyes (22 percent), and watery eyes (19 percent).

Shortcomings
The majority of the study population was elderly, educated Caucasians. This could have affected the results when it came to “self-diagnosed sinus headaches.” Also, not all the patients were assessed by otolaryngology experts (also known as ENT specialists) and many of the parameters were assessed using questionnaires. This could have skewed the actual results.

Conclusion
Results from this study have shown that most people with “self-diagnosed sinus headaches” actually suffer from migraine or probable migraine. There is potential for confusion between migraine and sinus related headaches due to their overlapping features. This study should alert physicians in their diagnosis of both conditions. The authors suggest more research in this area and development of foolproof criteria to make individual diagnosis of such headaches. This would “decrease the burden of illness and limit the cost of inappropriate diagnostic evaluations and treatment of this group of patients.”

For More Information:
The Sinus, Allergy and Migraine Study (SAMS)
Publication Journal: Headache 2007
By Eric Eross; David Dodick, MD; Arizona Neurological Institute, Scottsdale, Arizona and Mayo Clinic College of Medicine, Scottsdale, Arizona

*FYI Living Lab Reports Are Summaries of the Original Research.
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