New daily persistent headache with isolated sphenoiditis in children

Area of Science:

• Pediatrics
• Neurology
• Otolaryngology

Background:

• Isolated sphenoid sinusitis is uncommon in children, often presenting with vague symptoms.
• Severe headache can be the sole initial manifestation of this condition.
• New daily persistent headache (NDPH) is a challenging chronic headache disorder.

Purpose of the Study:

• To report two pediatric cases of isolated sphenoid sinusitis presenting as NDPH.
• To highlight the diagnostic challenges and successful treatment of this rare condition.

Main Methods:

• Case report of two pediatric patients with new daily persistent headache.
• Comprehensive diagnostic workup including neurological, ophthalmological, and laboratory tests.
• Brain magnetic resonance imaging (MRI) to identify sphenoid sinusitis.
• Treatment with oral antibiotics.

Main Results:

• Two children presented with new daily persistent headache, without typical sinusitis symptoms.
• Standard headache treatments and initial investigations were inconclusive.
• Brain MRI revealed isolated sphenoid sinusitis in both patients.
• Symptoms resolved completely after a one-month course of oral antibiotics.

Conclusions:

• Isolated sphenoid sinusitis should be considered in the differential diagnosis of new daily persistent headache in children, even without nasal symptoms.
• Early diagnosis via imaging and appropriate antibiotic therapy can effectively treat this condition.
• This presentation underscores the importance of considering non-neurological causes for persistent headaches in pediatric patients.