New rapid diagnostic criteria of acute sinusitis based on patterns of headache and facial pain in sinusitis: A study of 117 patients suffering from sinusitis

2018 ◽  
Vol 7 (1) ◽  
pp. 36-41
Author(s):  
Santhosh Kumar Rajamani

Introduction There is need for any healthcare setup to rapidly identify Sinus headache patients from other cases of Neurological and Primary headaches like Migraine and Chronic Tension-type headache. Materials and Methods 117 cases of confirmed sinusitis were evaluated and analyzed for common traits which could help in the rapid diagnosis of Sinusitis. Results Unilateral, dull aching headache and facial pain, of changing intensity, lasting all day on an average of 4 to 6 hours with a previous short history of the common cold in acute sinusitis is the most common pattern observed in this study. Discussion Unilateral, dull aching headache and facial pain, of variable intensity, lasting all day on an average of 4 to 6 hours along with is highly sensitive criterion (91%) for diagnosis of acute sinusitis. This, along with a history of previous Upper Respiratory tract infection, is useful to rapidly screen patients for acute sinusitis (95% sensitive). Though a subset of other headache cases will also be included by the criteria, imaging or Endoscopy must be done in these positive cases to increase the specificity of the diagnostic criteria.

Cephalalgia ◽  
2003 ◽  
Vol 23 (5) ◽  
pp. 348-355 ◽  
Author(s):  
A Chakravarty

Chronic daily headache (CDH) remains a relatively unexplored entity in India. Misconceptions are common, unnecessary investigations often done and inappropriate therapy prescribed. Analgesic overuse is seldom recognized. The present report appears to be the first of its kind from India. CDH has been defined as headaches occurring more than 15 days per month for more than 3 months (secondary causes excluded). Over 2 years (1998-1999) 849 cases (49.6% of all primary headaches) were seen. More than 1 year's follow-up data were available in 205 subjects (M 34; F 171). The distribution of these was as follows: (i), chronic tension-type headache (CTH), 33 (16.1%); (ii), chronic/transformed migraine (TM), 169 (82.4%); (iii), new persistent CDH, 3 (1.5%). There were 169 cases of TM (M:F 1:4.7; age 26-58 years). History of past episodic migraine was present in all. Transformation had been gradual (89.4%) or acute (10.6%). Possible factors in transformation included psychological stress (44.4%), analgesic overuse (28.4%), ergot overuse (4.1%). HRT seemed to be implicated in three female subjects. Analgesic overuse was limited between intake of 600 and 2400 mg of aspirin equivalent per day (mean 735 mg). Ergot overuse varied between 1 and 3 mg/day of ergotamine for ≥ 3 days/week. With medical therapy approximately 70% TM and 40% CTH patients noted significant improvement. About 80% of these relapsed on therapy withdrawal. CDH in India is not uncommon. Analgesic/ergot overuse needs to be recognized early. The average dose of analgesic implicated in CDH seems much less compared with that reported in the West.


Cephalalgia ◽  
2014 ◽  
Vol 34 (10) ◽  
pp. 745-751 ◽  
Author(s):  
BL Uhlig ◽  
M Engstrøm ◽  
SS Ødegård ◽  
KK Hagen ◽  
T Sand

Background Several epidemiological studies on the association between primary headaches and insomnia have been published in recent years. Both disorders are frequent, and our purpose was to review results from population-based studies exploring this association. Methods We performed a literature search in PubMed for “insomnia” (or sleep disturbance) and “headache” (or migraine) linked with “epidemiology.” Two hundred and eight records were identified. Three longitudinal and 10 cross-sectional studies met our inclusion criteria: population-based design with at least 200 participants including a numerical estimate of the association between headache and insomnia. Results and conclusions In nearly all studies, primary headaches, including migraine and tension-type headache, were significantly related to insomnia symptoms with OR estimates ranging from 1.4 to 1.7. The odds were even greater, from 2.0 to 2.6, for frequent, comorbid or severe headache. Recent large longitudinal studies from Norway found a bidirectional, possibly causal, association between headache and insomnia. However, not all studies used standardized diagnostic criteria for either headache or insomnia. Further research should use well defined and validated diagnostic criteria both for insomnia and headache types in order to improve the comparability between studies, investigate causality and clarify the relevance of the findings for clinical practice.


2021 ◽  
Vol 11 (1) ◽  
pp. 79
Author(s):  
Marcin Straburzyński ◽  
Anna Gryglas-Dworak ◽  
Magdalena Nowaczewska ◽  
Eliza Brożek-Mądry ◽  
Paolo Martelletti

‘Sinus headache and/or facial pain’ (SH) is a common complaint encountered by otorhinolaryngologists, neurologists and general practitioners. However, several studies suggested that the majority of those cases may be attributed to primary headaches (i.e., migraine and tension-type headache (TTH). The purpose of this review is to evaluate the etiology of SH. The first part includes cross-sectional studies analyzing the prevalence of respective diagnoses in subjects with SH. The majority of these publications indicate that migraine and TTH are the most prevalent causes of SH, although most of these studies were conducted in a clinical setting. The second part of this review included treatment trials in subjects with SH. The findings from this part of the review show that SH without rhinosinusitis responds well to pharmacotherapy targeted at primary headaches. This observation further supports a neurologic etiology of the majority of SH cases.


2017 ◽  
Vol 6 (15) ◽  
pp. 91
Author(s):  
Omar Franklin Molina ◽  
Marcus Sobreira Peixoto ◽  
Raphael Navarro Aquilino ◽  
Rise Rank

AIMS: explore the hypothesis that bruxism and depression are forms of suppressed hostility in individuals presenting Craniomandibular Disorders (CMDs) and Tension-type Headache (TTHa). METHODS: We evaluated a group of 100 Craniomandibular Disorders and Tension-Type Headache individuals, a group of 38 CMDs and Facial Pain individuals and a group of 23 No Craniomandibular Disorders No Facial Pain individuals. Clinical examination, questionnaires, history of signs and symptoms, the Beck Depression Inventory (BDI) and the Cook-Medley Inventory (HO) were used to gather data. RESULTS: The frequency of Tension Type Headache was about 43.5% in the group of 230 Craniomandibular Disorder patients. Mean scores in hostility were 19.0, 17.7 and 17.2 in the groups presenting Tension-Type Headache and CMDs, CMDs and Facial Pain and No CMDs no Pain, respectively. Mean scores in depression were about 12.0, 9.1 and 5.7 respectively in the same groups. Mean scores in bruxism were about 12.9, 8.2 and 6.8, respectively in the same groups. The strongest correlation between bruxism and depression were observed in the TTHa group (r=0.4, p<0.0001) and in the Non CMD Non Pain group (r=0.48, p<0.02). CONCLUSION: Depression is a better indicator of hostility in subgroups presenting TTHa. Scores in bruxism and depression as a form of suppressed hostility are higher in CMDs and TTHa individuals than in controls without TTHa. Because scores in bruxism were higher in TTHa and CMDs individuals, there is a strong and positive association between bruxism and TTHa in individuals with concomitant Craniomandibular disorders.


2017 ◽  
Vol 6 (15) ◽  
pp. 91-100
Author(s):  
Omar Franklin Molina ◽  
Marcus Sobreira Peixoto ◽  
Raphael Navarro Aquilino ◽  
Rise Rank

AIMS: explore the hypothesis that bruxism and depression are forms of suppressed hostility in individuals presenting Craniomandibular Disorders (CMDs) and Tension-type Headache (TTHa). METHODS: We evaluated a group of 100 Craniomandibular Disorders and Tension-Type Headache individuals, a group of 38 CMDs and Facial Pain individuals and a group of 23 No Craniomandibular Disorders No Facial Pain individuals. Clinical examination, questionnaires, history of signs and symptoms, the Beck Depression Inventory (BDI) and the Cook-Medley Inventory (HO) were used to gather data. RESULTS: The frequency of Tension Type Headache was about 43.5% in the group of 230 Craniomandibular Disorder patients. Mean scores in hostility were 19.0, 17.7 and 17.2 in the groups presenting Tension-Type Headache and CMDs, CMDs and Facial Pain and No CMDs no Pain, respectively. Mean scores in depression were about 12.0, 9.1 and 5.7 respectively in the same groups. Mean scores in bruxism were about 12.9, 8.2 and 6.8, respectively in the same groups. The strongest correlation between bruxism and depression were observed in the TTHa group (r=0.4, p<0.0001) and in the Non CMD Non Pain group (r=0.48, p<0.02). CONCLUSION: Depression is a better indicator of hostility in subgroups presenting TTHa. Scores in bruxism and depression as a form of suppressed hostility are higher in CMDs and TTHa individuals than in controls without TTHa. Because scores in bruxism were higher in TTHa and CMDs individuals, there is a strong and positive association between bruxism and TTHa in individuals with concomitant Craniomandibular disorders.


Cephalalgia ◽  
2009 ◽  
Vol 29 (4) ◽  
pp. 472-477 ◽  
Author(s):  
FI Ojini ◽  
Nu Okubadejo ◽  
MA Danesi

We investigated the 1-year prevalence, clinical features and mode of treatment of headache in medical students of the University of Lagos, Nigeria, using a self-administered headache questionnaire. Headache prevalence was 46.0% and was significantly higher in women than in men (62.8% vs. 34.1%). Prevalence of tension-type headache was higher than that of migraine (18.1% vs. 6.4%). Although tension-type headache had a similar prevalence in both sexes (male 17.3%, female 19.2%), migraine was three times more common in women (10.9% vs. 3.2%). A family history of headache was present in 22.0%. Only 4.6% sought medical assistance, whereas 68.2% took non-prescription drugs, mainly simple analgesics. Specific drugs for migraine and tension-type headache were rarely used. In conclusion, 1-year headache prevalence is high among medical students at this university. The low consultation rate and the rarity of usage of specific anti-headache drugs probably reflect inadequacies in the management of primary headaches in this population.


Cephalalgia ◽  
2005 ◽  
Vol 25 (10) ◽  
pp. 795-800 ◽  
Author(s):  
A Chakravarty

Chronic Daily Headache (CDH) is uncommon in Indian children compared to their adult counterpart. This is a retrospective study looking at the headache phenomenology of CDH in Indian children and adolescents. The validity of the case definitions of subtypes of chronic primary headaches mentioned in the HIS 2004 classification have been evaluated. 22 children (age range 8-15 years; M : F-16 : 6) diagnosed as having primary CDH using a modified definition seen between 2002 and 2003 have been studied. CDH has been defined as daily or near daily headaches > 15d/month for > 6 weeks. The rationale for this modified definition has been discussed. Majority of children (15/22) had a more or loss specified time of onset of regular headache spells resembling New Daily Persistent Headache (NDPH) but did not fulfil totally the diagnostic criteria of NDPH as laid down by IHS 2004. In all cases headache phenomenology included a significant vascular component. Headache phenomenology closely resembled Chronic Tension Type Headache (CTTH) in 4 patients and Chronic Migraine in 3 patients. However, in no patient in these groups, a history of evolution from the episodic forms of the diseases could be elicited. Heightened level of anxiety mostly related to academic stress and achievement was noted in the majority (19/22). Only a minority of patients (3/22) had anxiety and depression related to interpersonal relationships in the family. Medication overuse was not implicated in any patient. CDH in children in India is very much different from CDH in adults with the vast majority of patients exhibiting overlapping features of migraine and tension-type headache. There is need for a modified diagnostic criteria and terminology for chronic primary headaches in children.


Cephalalgia ◽  
2001 ◽  
Vol 21 (7) ◽  
pp. 748-752 ◽  
Author(s):  
P Tfelt-Hansen

Headache research in Denmark started with the description in 1949 by Dalsgaard-Nielsen of the percutaneous nitroglycerin test. In 1976 Jes Olesen started The Copenhagen Acute Headache Clinic and from that time modern headache research began in Denmark. Specific changes in regional cerebral blood flow during attacks of migraine with aura, spreading oligaemia, were described for the first time in 1980. The first headache classification with operational diagnostic criteria was published in 1988 and used in a Danish population study from 1989. The lifetime prevalence of migraine was 8% in men and 25% in women. An intravenous nitroglycerin test was introduced in 1989 and has been developed as an experimental headache model. In 1993 it was suggested by Jes Olesen et al. that NO supersensitivity could be a possible molecular mechanism of migraine pain. Recent genetic studies have supported the distinction between migraine with aura and migraine without aura. From the middle of the 1980s the pathophysiology of tension-type headache has been investigated and recent results indicate central sensitization in patients with chronic tension-type headache.


Cephalalgia ◽  
2013 ◽  
Vol 33 (16) ◽  
pp. 1311-1318 ◽  
Author(s):  
Francesco Margari ◽  
Elisabetta Lucarelli ◽  
Francesco Craig ◽  
Maria G Petruzzelli ◽  
Paola A Lecce ◽  
...  

Background Recurrent headache is common in childhood, but there is not a great amount of data on the associations between headaches and psychopathology in children. Objective The aim of this study is to examine the relationships between primary headaches and psychopathology in children, using both the categorical and dimensional assessment. Methods The sample consisted of 70 patients with primary headache compared to a matched sample of 50 healthy children. Psychiatric comorbidity was defined according to the diagnostic criteria of the Diagnostic and Statistical Manual of Disorders. Child psychopathology outcomes were assessed using child- and parent-reported standardized instruments. Results Internalizing and externalizing problems were significantly represented among children with headaches compared to the control group, respectively 63% and 27%, without significant differences between migraine and tension-type headache children. Moreover, a total of 26% of the children with a headache reported psychiatric comorbidity such as anxiety and mood disorders. Conclusion The dimensional approach improves accuracy in the recognition of emotional and behavioral problems compared to the categorical approach; however, the use of both of these approaches could be useful for clinical practice, treatment and research.


Cephalalgia ◽  
2018 ◽  
Vol 39 (6) ◽  
pp. 761-784 ◽  
Author(s):  
Rachel Potter ◽  
Katrin Probyn ◽  
Celia Bernstein ◽  
Tamar Pincus ◽  
Martin Underwood ◽  
...  

Background or aim Despite guidelines and the International Classification of Headache Disorders (ICHD-III beta) criteria, the diagnosis of common chronic headache disorders can be challenging for non-expert clinicians. The aim of the review was to identify headache classification tools that could be used by a non-expert clinician to classify common chronic disorders in primary care. Methods We conducted a systematic literature review of studies validating diagnostic and classification headache tools published between Jan 1988 and June 2016 from key databases: MEDLINE, ASSIA, Embase, Web of Knowledge and PsycINFO. Quality assessment was assessed using items of the Quality of Diagnostic Accuracy Studies (QUADAS-2). Results The search identified 38 papers reporting the validation of 30 tools designed to diagnose, classify or screen for headache disorders; nine for multiple headache types, and 21 for one headache type only. We did not identify a tool validated in a primary care that can be used by a non-expert clinician to classify common chronic headache disorders and screen for primary headaches other than migraine and tension-type headache in primary care. Conclusions Despite the availability of many headache classification tools we propose the need for a tool that could support primary care clinicians in diagnosing and managing chronic headache disorders within primary care, and allow more targeted referral to headache specialists.


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