Frank MiuccioIT Director
Samantha CloseAlex ForbessJin HuangJillian KwongWilliam McClainLin ZhangEditorial Research Staff
Of course it is possible for the migraine sufferer to develop a sinus infection, especially if you also have seasonal allergies. In fact, many suspected sinus headaches are migraines.
Here's how that works: the sinus cavities are lined by sensitive tissues whose nerves are fed mostly by a branch of the trigeminal nerve. This is the same nerve responsible for migraine headaches. When you have sinus congestion, it can confuse the nerves and cause what is called referred pain, sending pain to distant areas in the face and head, away from the sinuses themselves. So, sinus headaches may cause pain that is not in the sinus region, and migraines can cause pain that is in the sinus region. Just to make things even more confusing, some migraine sufferers experience nasal congestion or watery eyes with their migraine attacks. This is because the trigeminal nerves can release neurotransmitter chemicals that cause blood vessels to dilate, which is why your eyes get red and watery and your nose gets congested.It isn't clear why this happens more to some people and not to others with migraine.
The Sinus, Allergy and Migraine Study investigated 100 subjects self-diagnosed with sinus headache. They were then evaluated by headache specialists, and 63% were diagnosed with either migraine with aura or migraine without aura, and 23% with probable migraine. Only 3% actually had sinusitis. Interestingly, 62% reported that exposure to allergens was a significant headache trigger. Although the symptoms can overlap, these general guidelines can help somewhat in telling migraine and acute sinus infection apart. Sorting out chronic sinus headache is more difficult, especially if there is also another type of chronic headache present.
These are the major features of a sinus infection:
Discharge thick, yellowish-green*
Diminished or absent sense of smell*
halitosis (bad breath), cough, headache, dental pain, ear pressure, fatigue
Facial pain or pressure—more likely to be non- throbbing
Sinus CT or direct examination positive
Features of a migraine headache:
Often (not always!) one-sided*
Discharge thin, clear if present
Heightened or altered sense of smell or avoidance of odors
Occasional symptom: watery, red eyes Facial pain or pressure—more likely to be throbbing or pulsating*
Diagnosis based on symptoms.
*Major features of each disorder.
Sinusitis occurs in 15% of the population— and that is even higher than migraine, unless we take into consideration the possibility of overdiagnosis of acute sinusitis in the migraine population.
As if this were not confusing enough, there is another headache type called Contact Point headache. This occurs when you have a deviated septum or bone spurs in the nose, and the bone from the center of your nose comes in contact with the sensitive tissue on the other side of your nose. This can cause headaches that can feel very much like a migraine.