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Prevalence of Migraine in Patients With a History of Self-reported or Physician-Diagnosed "Sinus" Headache
Curtis P. Schreiber, MD;
Susan Hutchinson, MD;
Christopher J. Webster, BS;
Michael Ames, PhD;
Mary S. Richardson, PharmD, BCPS;
Connie Powers, BSMT
Arch Intern Med. 2004;164:1769-1772.
Background Symptoms referable to the sinus area are frequently reported during migraine attacks, but are not recognized in diagnostic criteria. Underrecognition of migraine may be partly attributed to a variable clinical presentation, and migraines with "sinus" symptoms contribute to this problem. This study was conducted to determine the prevalence of migraine-type headache (International Headache Society [IHS]–defined migraine without aura [IHS 1.1], migraine with aura [IHS 1.2], or migrainous disorder [IHS 1.7]) in patients with a history of self-described or physician-diagnosed "sinus" headache.
Methods During a clinic visit, patients with a history of "sinus" headache, no previous diagnosis of migraine, and no evidence of infection were assigned an IHS headache diagnosis on the basis of headache histories and reported symptoms.
Results A total of 2991 patients were screened. The majority (88%) of these patients with a history of self-described or physician-diagnosed "sinus" headache were diagnosed at the screening visit as fulfilling IHS migraine criteria (80% of patients) or migrainous criteria (8% of patients). The most common symptoms referable to the sinus area reported by patients at screening were sinus pressure (84%), sinus pain (82%), and nasal congestion (63%).
Conclusions In this study, 88% of patients with a history of "sinus" headache were determined to have migraine-type headache. In patients with recurrent headaches without fever or purulent discharge, the presence of sinus-area symptoms may be part of the migraine process. Migraine should be included in the differential diagnosis of these patients.
From the Headache Care Center, Springfield, Mo (Dr Schreiber); Women's Medical Group of Irvine, Irvine, Calif (Dr Hutchinson); and GlaxoSmithKline, Research Triangle Park, NC (Mr Webster, Drs Ames and Richardson, and Ms Powers). Dr Hutchinson has served as a consultant for Abbott Laboratories, AstraZeneca, Eli Lilly and Company, GlaxoSmithKline, Merck & Co Inc, Organon, Ortho-McNeil Pharmaceutical Inc, Parke-Davis, Pfizer Inc, and Wyeth-Ayerst, and on speakers bureaus for AstraZeneca, Eli Lilly and Company, GlaxoSmithKline, Merck & Co Inc, Organon, Ortho-McNeil Pharmaceutical Inc, and Pfizer Inc. Mr Webster, Drs Ames and Richardson, and Ms Powers are employees of and have stock options in GlaxoSmithKline.
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