The aetiology underlying sinus headaches

Kaymakçı, Mustafa; Çıkrıklar, Halil İbrahim; Pay, Güneş

doi:10.1177/0300060513475382

Cited by 7 publications

(6 citation statements)

References 22 publications

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“…The nasal congestion and increased severity of her headaches while lying down suggested maxillary sinus pathology. 12 The likely etiology of the patient's headaches, and facial pain was referred pain from the inflamed nasal mucosa.…”

Section: Discussionmentioning

confidence: 99%

Granulomatosis with polyangiitis mistaken as a temporomandibular joint disorder: A case report

Hernández

Friesen

McGaw

et al. 2021

Clin Adv Periodontics

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Introduction: Granulomatosis with polyangiitis (GPA), is a rare systemic disease that if left untreated, it may lead to death within 6-12 months. This case report describes a 15-year-old female with a 14-month history of epiphora, nasal breathing difficulties, headaches, and jaw pain. The patient reported having various medical procedures attempted to address her symptoms. The classical presentation of strawberry gingivitis led to the diagnosis of GPA. Based on a multi-language search, this is the first reported case, that GPA is mistaken as Temporomandibular Joint Disorders (TMD). Case Presentation: A 15-year-old female with nearly 14 months of numerous complaints, including headaches and jaw pain, was referred for an orofacial pain (OFP) consultation. The patient had completed a dental examination and was prescribed chlorhexidine for gingivitis control. The OFP examination was not consistent with signs and symptoms of TMD. However, the gingival appearance of strawberry gingivitis was suggestive of GPA. A rheumatologist confirmed the diagnosis of GPA based on the clinical interview, serology testing, and dental findings. A course of rituximab and corticosteroids, and regular dental cleanings were recommended. A 4-month follow-up visit demonstrated complete resolution of her jaw pain and headaches. Gingival tissue appeared normal. Conclusion: This case emphasizes the need for familiarity with systemic diseases that can present oral manifestations. It also stresses the importance for dental professionals to be knowledgeable of differential diagnoses for TMD, headaches, and autoimmune disorders. K E Y W O R D Sgingival hyperplasia, oral medicine, pain, pathology -oral, temporomandibular disorders, strawberry gingivitis Why is this case new information?• This is believed to be the first published case mistaking GPA as TMD.• This is a case in which a multidisciplinary approach and management were keys for a successful treatment outcome.What are the keys to successful management of this case?• Obtain a thorough clinical history.• Know the oral manifestation of systemic diseases.• Know differential diagnosis of TMD and headaches.

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Section: Discussionmentioning

confidence: 99%

Granulomatosis with polyangiitis mistaken as a temporomandibular joint disorder: A case report

Hernández

Friesen

McGaw

et al. 2021

Clin Adv Periodontics

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“…However, studies in adults have shown that a large proportion of patients with a diagnosis of sinus headache and no evidence of acute pathology are ultimately diagnosed with a primary headache disorder such as migraine, tension headache, or cluster headache . Incorrect diagnosis in these patients leads to unnecessary treatment for sinusitis or anatomic abnormalities, which does not improve headache symptoms . In some studies, as many as 60‐80% of patients with primary headache reported previous unsuccessful treatment for sinusitis, including antibiotics, and 10‐15% had undergone unsuccessful septoplasty for headaches thought to be related to a deviated nasal septum …”

Section: Discussionmentioning

confidence: 99%

“…Incorrect diagnosis in these patients leads to unnecessary treatment for sinusitis or anatomic abnormalities, which does not improve headache symptoms . In some studies, as many as 60‐80% of patients with primary headache reported previous unsuccessful treatment for sinusitis, including antibiotics, and 10‐15% had undergone unsuccessful septoplasty for headaches thought to be related to a deviated nasal septum …”

Section: Discussionmentioning

confidence: 99%

“…However, it is not known whether this same trend is present in pediatric patients. In patients with a complaint of sinus headache and a normal examination, it is critically important that the distinction between potential etiologies is made, because, as a result of misdiagnosis, patients continue to suffer from chronic headaches and undergo unnecessary medical and/or surgical treatments for suspected rhinogenic pathologies . This is in contrast to the observation that many patients with a diagnosis of sinus headache are responsive to standard migraine therapy, such as sumatriptan .…”

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confidence: 99%

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Rhinogenic headache in pediatric and adolescent patients: an evidence‐based review

Smith

George

Svider

et al. 2019

Int Forum Allergy Rhinol

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Background: Although some causes of rhinogenic headache, such as acute sinusitis, have clear diagnostic criteria, others, such as "sinus headache" and mucosal contact points, are more nebulous. Misdiagnosis of these entities and primary headaches may result in unnecessary medical or surgical treatment. The purpose of this systematic review is to delineate current understanding of diagnosis and treatment of rhinogenic headaches, including sinus and mucosal contact point headaches, in children. Methods:PubMed, SCOPUS, and the Cochrane databases were searched for studies on sinus headache and mucosal contact point headaches in children. Studies were assessed for level of evidence, and risk of bias was assessed by Methodological Index for Non-Randomized Studies (MI-NORS) scoring. Diagnostic criteria, management strategies, and other clinical data were analyzed. Results:Eight studies met the inclusion criteria. Level of evidence was predominantly 4. Forty percent of pediatric patients with migraine had been previously misdiagnosed with sinus headache. Of 327 pediatric patients in two studies, between 55% and 73% had at least 1 cranial autonomic symptom associated with their migraine. For children with mucosal contact point headaches, surgical management in select patients improved headache intensity or severity in 17 (89%) cases. Conclusion:The majority of pediatric patients with sinus headache harbor a primary headache disorder, with migraine being most common. Physicians should suspect primary headache disorders in pediatric patients with chronic headaches and a normal exam. Although some case series are supportive of surgical management for mucosal contact point headaches in children, the level of evidence supporting these recommendations is insufficient. High-quality clinical trials are necessary for continuing to improve outcomes in patients with these clinical entities. C 2019 ARS-AAOA, LLC.

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“…After negative endoscopic and imaging findings, they subsequently received a primary headache diagnosis, predominately migraine; 6% were diagnosed with CH. Eighty‐nine percentage of this cohort had clinically improved at 3 months (Kaymakci et al , ).…”

Section: Secondary Headache Disordersmentioning

confidence: 97%

Trigeminal autonomic cephalalgias

Eller

Goadsby

2014

Oral Diseases

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The trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders characterised by lateralized symptoms: prominent headache and ipsilateral cranial autonomic features, such as conjunctival injection, lacrimation and rhinorrhea. The TACs are: cluster headache (CH), paroxysmal hemicrania (PH), short‐lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)/short‐lasting neuralgiform headache attacks with cranial autonomic features (SUNA) and hemicrania continua (HC). Their diagnostic criteria are outlined in the International Classification of Headache Disorders, third edition‐beta (ICHD‐IIIb). These conditions are distinguished by their attack duration and frequency, as well as response to treatment. HC is continuous and by definition responsive to indomethacin. The main differential when considering this headache is chronic migraine. Other TACs are remarkable for their short duration and must be distinguished from other short‐lasting painful conditions, such as trigeminal neuralgia and primary stabbing headache. Cluster headache is characterised by exquisitely painful attacks that occur in discrete episodes lasting 15–180 min a few times a day. In comparison, PH occurs more frequently and is of shorter duration, and like HC is responsive to indomethacin. SUNCT/SUNA is the shortest duration and highest frequency TAC; attacks can occur over a hundred times every day.

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The aetiology underlying sinus headaches

Cited by 7 publications

References 22 publications

Granulomatosis with polyangiitis mistaken as a temporomandibular joint disorder: A case report

Granulomatosis with polyangiitis mistaken as a temporomandibular joint disorder: A case report

Rhinogenic headache in pediatric and adolescent patients: an evidence‐based review

Trigeminal autonomic cephalalgias

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