Migraines can be a real headache!

The diagnosis and treatment of migraines has been one of a significant challenge for many medical specialist. Not all headaches are migraines, and not all migraines manifests as headaches. There are some specific guidelines about the number of features that need to be present in order to make the correct diagnosis of migraine disease. These guidelines are very rigid in their definition of symptoms and frequency of those symptoms. However, many healthcare professions might use the diagnosis of migraines more loosely.

Specifically for ear, nose, and throat disorders, migraine disease has been recently found to be a complicating factor in diagnosing other related patient problems. Perhaps the most common is the confusion between genuine sinus disease, versus sinus headache, versus migraine symptoms that masquerade as sinus disease. Patients may independently suffer from sinus disease as well as migraines, and the onset of each can trigger symptoms for the other. However, a more frustrating challenge is the management of patient’s with sinus type headaches with lack of any other specific sinus symptoms. Generally, patients suffering from sinus disease, are expected to have some degree of congestion, runny nose, postnasal dripping, obstruction of the breathing passages, pus coming out from the nasal passages, fevers, chills, or general sensation of lack of energy. If none of those sinus specific symptoms are present, the patient is then most likely suffering from migraine manifestation in the sinuses rather than genuine sinus infection.

Another area where migraine disease can be a complicating factor in diagnosis is dizziness. Positional dizziness, vestibulitis, and other such diseases give patient issues with vertigo. This is specifically described as a condition where the patient feels the room rotating around them, and most often these could be related to specific motions of the head or the body. However, there is a significant subset of patients who present with generalized lack of balance, lightheadedness, and a sensation of being foggy. These patients may actually be suffering from what is called vestibular migraines. Specifically, the constrictive properties of migraine disease may be affecting the organ of balance, and lack of proper oxygenation and nerve transmission can then lead to dizziness. In these patients, attention should be once again focused at treatment of migraine type symptoms rather than medicines geared at the symptoms of dizziness.

Patient suffering from migraine disease might benefit from consulting their ear, nose, and throat doctor as well as specific headache specialist in order to differentiate migraine disease from other problems. A more specific and correct diagnosis can help patients achieve much better outcomes.

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Posted in: Ears, Sinuses

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