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Facial migraine in a rhinological setting
1Department of Otorhinolaryngology, Head and Neck Surgery, University of Nottingham, Nottingham, UK.
Clinical Otolaryngology and Allied Sciences
|December 11, 2002
Summary
Migraine involving the face is common in rhinology clinics, affecting 12% of patients with facial pain. A significant subset experiences migraine localized to the trigeminal nerve
Area of Science:
- Otorhinolaryngology
- Neurology
- Headache Medicine
Background:
- Facial pain and rhinosinusitis symptoms are common presentations in rhinology clinics.
- Migraine, particularly when presenting as facial pain, is often underdiagnosed or misdiagnosed in this setting.
- The International Headache Society (IHS) provides diagnostic criteria for migraine.
Purpose of the Study:
- To determine the incidence of migraine presenting with facial pain in a rhinology clinic.
- To characterize the clinical features of facial migraine in this patient cohort.
- To highlight a potentially underrecognized subtype of migraine affecting the trigeminal nerve.
Main Methods:
- A cohort study of 973 consecutive patients presenting with facial pain and/or rhinosinusitis symptoms.
- A subgroup analysis of 51 patients diagnosed with migraine based on IHS criteria.
- Diagnosis confirmation and treatment response assessed over a mean follow-up of 2 years and 2 months.
Main Results:
- 42% of patients reported facial pain and/or head pressure.
- Migraine was diagnosed in 12% of patients presenting with facial pain.
- Migraine predominantly affected the forehead, eye, or cheek (63%), with 47% isolated to the second division of the trigeminal nerve.
Conclusions:
- Migraine is a significant diagnosis in patients presenting with facial pain to rhinology clinics.
- Migraine confined to the second division of the trigeminal nerve is a distinct entity observed in 6% of cases.
- Increased awareness and recognition of facial migraine are needed in rhinology practice.