Two studies recently presented at the 54th Annual Scientific Meeting of the American Headache Society assert that migraine frequency and headache-related disability are greater among migraineurs with rhinitis (runny nose) than among migraineurs without it.  According to Vincent T. Martin, MD, Clinical Professor of General Medicine at the University of Cincinnati, the increases are especially pronounced among migraineurs who have a blend of allergic and nonallergic rhinitis, which is called mixed rhinitis. “The differences between the rhinitis and control groups were most evident in the highest percentiles of migraine frequency. This could imply that the association between rhinitis subtypes and migraine frequency and disability is most pronounced in those with more frequent migraines,”  said Dr. Martin.

In one of the studies, patients were assigned into rhinitis and non-rhinitis groups.  The rhinitis group was further categorized into groups for individuals with allergic rhinitis, nonallergic rhinitis, mixed rhinitis, and unclassified rhinitis.  The unclassified rhinitis group was based on the presence or absence of specific allergic triggers, such as dogs, cats and mold, and non-allergic triggers such as cigarette smoke, perfumes, and weather.  Headaches were more frequently seen in patients with rhinitis, and within the subtypes of rhinitis the incidence of headache frequency was notably higher in patients with mixed rhinitis, and unclassified rhinitis.

Dr. Martin said that the pathophysiology of migraine has concentrated on the activation of afferent trigeminal neurons in the brain.  He suggested these new study results may point to the possibility that the afferent trigeminal neurons in the nose or paranasal sinuses could also contribute to triggering a migraine. “The nose is the only exposed mucosa in the body and is primed to sense chemical and allergic triggers in the environment.  Why couldn’t it be involved in migraine pathogenesis?  Therapies that block allergies, such as immunotherapy (allergy shots), and nasal antihistamines or steroids should be studied to determine whether they decrease the frequency of headaches in migraineurs.”         Neurology Reviews   September, 2012


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