Diagnostic errors of migraine in adults
Migraine sufferers are often mistakenly attributed to headaches for diseases of the paranasal sinuses. A survey of 100 patients who independently diagnosed sinus headaches revealed that 85% of them had migraines and only 3% had a headache caused by rhinosinusitis.
It happened that patients with an established diagnosis of migraine mistakenly perceived some signs of headaches as a manifestation of pathology on the part of the paranasal sinuses.
Moreover, migraine headaches are often stopped by antihistamines, which reinforces the erroneous view of the pathology of the sinuses as the cause of headaches.
Symptoms of the nasal sinuses that occur during the attacks of headaches in patients with a diagnosis of migraine:
1. Pain over sinus area (s): 97%
2. Nasal congestion: 56%
3. Edema of eyelids: 37%
4. Nasal discharge: 25%
5. Conjunctival injection: 22%
6. Tearing: 19%
7. Ptosis: 3%
8. Sinus Triggers:
– change in weather conditions
– season change – 73%
– susceptibility to the action of allergens – 62%
– change in height above sea level – 38%
Sometimes a migraine is mistakenly diagnosed as a puffy headache. It is noteworthy that patients with beam headaches rarely complain of vegetative symptoms accompanying headaches, which is probably due to the high intensity of pain.
In contrast, persons suffering from migraine, often exaggerate the frequency and intensity of vegetative manifestations. Thus, in a study involving 841 patients suffering from migraine, it was found that during attacks of migraine, every fourth systematically experiences autonomic symptoms of unilateral localization.
In the course of this study, autonomic manifestations were less common in comparison with the previously described study of headaches in the pathology of the paranasal sinuses, since the study included patients with unilateral autonomic symptoms.
Unilateral “cluster” symptoms in patients with an established diagnosis of migraine:
1. Any unilateral symptom: 27%
2. Tearing: 11%
3. Conjunctival injection: 7%
4. Ptosis / miosis: 5%
5. Nasal congestion / discharge: 5%
6. Eyelid swelling: 4%