Prevalence of migraine in patients with a history of self-reported or physician-diagnosed "sinus" headache

Arch Intern Med. 2004 Sep 13;164(16):1769-72. doi: 10.1001/archinte.164.16.1769.


Background: Symptoms referable to the sinus area are frequently reported during migraine attacks, but are not recognized in diagnostic criteria. Underrecognition of migraine may be partly attributed to a variable clinical presentation, and migraines with "sinus" symptoms contribute to this problem. This study was conducted to determine the prevalence of migraine-type headache (International Headache Society [IHS]-defined migraine without aura [IHS 1.1], migraine with aura [IHS 1.2], or migrainous disorder [IHS 1.7]) in patients with a history of self-described or physician-diagnosed "sinus" headache.

Methods: During a clinic visit, patients with a history of "sinus" headache, no previous diagnosis of migraine, and no evidence of infection were assigned an IHS headache diagnosis on the basis of headache histories and reported symptoms.

Results: A total of 2991 patients were screened. The majority (88%) of these patients with a history of self-described or physician-diagnosed "sinus" headache were diagnosed at the screening visit as fulfilling IHS migraine criteria (80% of patients) or migrainous criteria (8% of patients). The most common symptoms referable to the sinus area reported by patients at screening were sinus pressure (84%), sinus pain (82%), and nasal congestion (63%).

Conclusions: In this study, 88% of patients with a history of "sinus" headache were determined to have migraine-type headache. In patients with recurrent headaches without fever or purulent discharge, the presence of sinus-area symptoms may be part of the migraine process. Migraine should be included in the differential diagnosis of these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analgesics / therapeutic use
  • Diagnosis, Differential
  • Female
  • Headache / diagnosis
  • Headache / drug therapy
  • Headache / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / diagnosis
  • Migraine Disorders / drug therapy
  • Migraine Disorders / epidemiology*
  • Paranasal Sinus Diseases / diagnosis
  • Paranasal Sinus Diseases / drug therapy
  • Paranasal Sinus Diseases / epidemiology*
  • Prevalence
  • Prospective Studies
  • Self Disclosure
  • Treatment Outcome


  • Analgesics