Does nasal disease cause headaches?

Abstract

It is uncommon for a headache that is due to rhinosinusitis (aka "sinus headache") to occur. In such a situation, an initial sinus infection by a viral or bacterial pathogen leads to formation of a viscous, discoloured discharge from the nose, hyposmia or anosmia, pain or a sense of pressure in the facial region and usually pyrexia. Pain in the face and headache normally abate within a week of the infection resolving. Ongoing pain should prompt a review of the diagnosis. The International Classification of Headache Disorders has published useful criteria which may be used to distinguish different kinds of headache. In sinus headache, pain over the face, facial pressure, blockage of the nose and sinuses are present. Additionally, the following symptoms, which are also present in migraine disorders, may occur: nausea, photosensitivity or noise intolerance, moderate to severe headache, a pulsatile or throbbing sensation and exacerbation due to activity. Despite the popularity of the term "sinus headache" among patients themselves and general practitioners, in the media and in advertising copy, its use is deprecated by ENT specialists, allergists and neurologists, who feel that the term lacks precision and may lead to inappropriate interventions. The term sinus headache is generally applied when a headache is accompanied by pain in the face or facial pressure. It is the facial pain and pressure that brings the association with sinus disease. In this chapter, nasal diseases and headache are reviewed.