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Clinical Challenges in Otolaryngology
February 2000

Using Vision Changes to Differentiate Sinonasal Headache From Migraine

Author Affiliations

KAREN H.CALHOUNMDRONALD B.KUPPERSMITHMDJohnFornadleyMDFrom the Division of Otolaryngology, Milton S. Hershey Medical Center, Hershey, PA

Arch Otolaryngol Head Neck Surg. 2000;126(2):231-233. doi:10.1001/archotol.126.2.231

In patients with headache, vision disturbance provides a primary differentiation between migraine headaches and headaches of sinonasal origin.

Patients experiencing episodes of recurrent anterior facial pain present a dilemma for accurate and cost-effective diagnosis. Discomfort in this area is usually either a manifestation of a headache disorder, such as migraine, or related to underlying chronic sinusitis. A small minority of patients suffer from disorders such as neuralgias or atypical pain syndromes. Unlike acute sinusitis, which usually occurs as pain overlying the affected sinus, patients with chronic sinonasal disease experience a more diffuse headache pattern as a primary symptom. The characteristics and location can be difficult to distinguish from migraine cephalgia. On the other hand, migraine headache is known to be associated with specific visual changes called visual aura. Could these vision changes be useful in differentiating migraine headache from sinusitis?

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