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Debunking Myths: Sinus Headache

  • Headache (R.B. Halker Singh and J. VanderPluym, Section Editors)
  • Published:
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Abstract

Purpose of Review

Although sinus headache has been extensively reviewed and described, misdiagnosis remains common. This paper discusses the myths and truths about sinus headaches.

Recent Findings

Sinus headache is used colloquially to attribute facial pain to allergies or a sinus infection; however, most sinus headaches are migraine. Sinus-region pain from sinusitis and migraine share the same origins in the trigeminovascular system, but their causes are very different. After reviewing sinus anatomy and sinogenic pain, we provide information to assist clinicians in correctly diagnosing patients with the additional goal of avoiding unnecessary investigations and treatments. Migraine medications can be used as both a treatment and a diagnostic tool. Other differential diagnoses of facial pain are discussed.

Summary

Sinus headache is not a diagnosis. All patients with facial pain or pressure with sinus symptoms should be evaluated for migraine because most sinus headache presentations are migraine and require migraine-directed treatment.

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Abbreviations

ARS:

acute rhinosinusitis

CGRP:

calcitonin gene-related peptide

CRS:

chronic rhinosinusitis

CT:

computed tomography

ICHD:

International Classification of Headache Disorders

RS:

rhinosinusitis

SNOT-22:

22-item Sino-Nasal Outcome Test

TACs:

trigeminal autonomic cephalgias

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Acknowledgements

The authors thank the staff of Neuroscience Publications at Barrow Neurological Institute for assistance with manuscript preparation.

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  1. Department of Neurology, Barrow Neurological Institute c/o Neuroscience Publications, St. Joseph’s Hospital and Medical Center, 350 W. Thomas Rd, Phoenix, AZ, 85013, USA

    Jennifer Robblee & Karissa A. Secora

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  1. Jennifer Robblee
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Robblee and Secora both performed the literature search and wrote the manuscript.

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Correspondence to Jennifer Robblee.

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Robblee, J., Secora, K.A. Debunking Myths: Sinus Headache. Curr Neurol Neurosci Rep 21, 42 (2021). https://doi.org/10.1007/s11910-021-01127-w

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