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Sumatriptan is Effective in Migraine
Presenting as "Sinus Headache"
Gary Ishkanian, MD, Harvey Blumenthal, MD, etal.
Posted November 2002  
Presented at: AHS Conference, Seattle, WA, June 21-23, 2003

Background:   Of the approximately 14 million undiagnosed migraineurs who meet criteria for migraine as defined by the International Headache Society (IHS), 42% reported a physician diagnosis of "sinus headache". Headache is only a minor feature of rhinosinusitis. "Sinus" symptoms such as sinus pain/pressure, nasal congestion and runny nose may be clinical features of migraine. Recent studies show that more than 80% of subjects presenting with "sinus headache" actually met IHS criteria for migraine with or without aura. Small open-label studies suggest that sumatriptan is an effective treatment for migraines presenting as "sinus headache".

Objective:   To determine if oral sumatriptan 50 mg. is effective in the treatment of migraine with or without aura in patients who previously described their headaches as "sinus headache".

Methods:   Eligible patients presenting with self-described or physician-diagnosed "sinus headache" and who were determined to have migraine were randomized to treat their next typical "sinus headache" of moderate or severe pain with one oral sumatriptan 50 mg. tablet or matching placebo. Use of sinus/nasal medications in the preceding 24 hours was not allowed. Additional medication for the treatment of migraine pain or sinus symptoms could not be taken for 2 hours after treatment. Migraine pain and associated symptoms and sinus/nasal symptoms were captured in diaries. The primary endpoint was headache response (moderate to severe headache pain to mild or none) at 2 hours.

Conclusions:   Sumatriptan is effective and well tolerated in the treatment of migraine presenting as "sinus headache".