Don't Let Yesterday Take Up Too Much Of Today-15The association between seasonal allergies and headaches has been well documented in several studies. A recent study found that headaches are 1.5 times more common in those with atopic conditions (asthma, seasonal allergic rhino sinusitis, chronic bronchitis) than those without these disorders. This relationship suggests that inflammatory changes in the nasal and sinus mucosa of individuals with seasonal allergic rhino sinusitis could be a potential trigger for migraines.

Allergies may also partly explain the seasonal variation experienced by many migraine sufferers. However, several primary headache disorders, including migraine, are at least partly characterized by the presence of cranial autonomic symptoms (e.g., conjunctival injection, lacrimation, eyelid edema, rhinorrhea, nasal congestion, postnasal drip,  and reddening of the face and ears) which closely resemble the signs and symptoms of seasonal allergic rhino sinusitis. This overlap in symptomatic presentation can make it quite difficult to clinically distinguish headache secondary to seasonal allergic rhino sinusitis from primary headache associated with cranial autonomic symptoms. Accurate characterization of these headaches through a detailed history and physical examination is crucial since appropriate treatment highly depends upon a proper diagnosis.

Many patients who believe they have sinus headaches are suffering from migraine. In fact, sinus headache is the most common misdiagnosis of patients with migraine. For its part, the International Headache Society (IHS) does not recognize sinus headache as a diagnostic entity – unless it is associated with a confirmed diagnosis of underlying acute rhino sinusitis.

Advanced Headache Therapy

Lawrence Robbins, M.D.

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