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Sinus Migraine

Sinus headache and migraine are commonly confused because the two share many of the same symptoms – making it hard to distinguish between sinus headache and migraine. In fact, nasal symptoms often occur along with many types of migraines although sinus symptoms are not included in the official information for diagnosing migraines. Actually, sinus headache isn’t an official diagnosis, but something that is often used by the public and doctors alike to describe a pain that starts near the nose and includes nasal symptoms.

The International Headache Society, which does not recognize the term sinus migraine, states that most people who believe they have sinus headaches, actually suffer from migraine without aura with sinus symptoms. Doctors even mistake migraine symptoms for sinus headache. Because only half of people who suffer from migraines have actually been diagnosed by a doctor, migraine sufferers often mistakenly label their migraine attacks as sinus headaches.

The IHS blames head pain on rhinosinusitis – inflammation of the sinuses if there is head pain the front, there is clinical, laboratory or MRI evidence of rhinosinusitis and the head or facial pain goes away after successful treatment of the rhinosinusitis or within seven days of the inflammation going away.

Symptoms of migraine vs. sinus headache

  • Facial pain
  • Sinus pressure
  • Nasal congestion
  • Runny nose
  • Teary eyes
  • Head pain triggered by weather changes
  • Pulsating pain
  • Puffy eyelid
  • Migraine does not have heavy, pus-like nasal discharge
  • Migraine does not cause post-nasal drip and sore throat
  • Migraine does not cause fever
  • Migraines usually are recurring and impact daily functioning
  • Sinus headache doesn’t cause nausea and/or vomiting
  • Sinus headache doesn’t cause light sensitivity, photophobia

Forty-two percent of patients with migraines are incorrectly diagnosed by a doctor with sinus headache

A 2004 study of 2,991 patients who thought they had a sinus headache or were told so by a physician found that the majority of the patients had migraines with sinus symptoms. In the study 88 percent met the IHS migraine criteria. Sinus symptoms reported in the study were sinus pressure, 84 percent; sinus pain, 82 percent; and nasal congestion, 63 percent. The researcher in the study said that because the trigeminal vascular system – the system that controls blood flow in the brain – is a main cause of migraine head pain, it can easily be blamed for the runny nose, nasal congestion and eye symptoms many migraine sufferers report.

In the 2007 Sinus, Allergy and Migraine Study, 100 adults responded to a newspaper ad if they thought they had a sinus headache. Of the responders, 63 were diagnosed with migraine and another 23 percent with probable migraine. Twenty-two subjects who were later diagnosed with migraine had prior sinus surgery to repair what they thought were sinus headaches.


Sinus Migraine Treatment

Treatment with the triptan class of medications works for many patients if taken when the head pain is in a mild stage. Misdiagnosis as sinus headache can lead to the overuse of several medications such as allergy, sinus and antibiotic medicines.

As with all migraines, it is very important to keep an accurate record, a log of all attacks. A migraine journal is a very good way to keep track of migraine symptoms, migraine triggers, what happened before the migraine attack and how long it lasted.


Written by: Otesa Miles | Last reviewed: August 2014