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        New Message Board Archives >> 2004 Cluster Headache Specific Posts >> Help, sinus headaches or CH?
        
(Message started by: maria9 on Feb 14^th, 2004, 10:45pm)

Title: Help, sinus headaches or CH?
Post by maria9 on Feb 14^th, 2004, 10:45pm

Hi all,

A brief history here, CH sufferer since I was 16 yearly episodic (6-8 weeks) for 22 years, a five year break from the beast, one cycle and then no CH cycles since then almost 4 years.

Almost two weeks ago I got a bad cold which has turned into a ear infection and possibly a sinus infection. Damn, if the sinus headache does not feel like a CH at times, only difference it disappears more quickly once I get up and start moving.

Oh and yes, I have been to a neurologist, many moon ago and his comment was "you are a classic cluster head except you are a woman"

But to get on with my story, why is my sinus headache so much like my CH? Does this possibly mean I am heading into another CH cycle? If you have a sinus headache why can't the darn thing be on the opposite side of what you would expect?

Anybody else out there have any insight about sinus vs. cluster headaches?

PS. I am sick of both of them

Maria :(

Title: Re: Help, sinus headaches or CH?
Post by Pinkfloyd on Feb 15^th, 2004, 1:01am

on 02/14/04 at 22:45:32, maria9 wrote:

Damn, if the sinus headache does not feel like a CH at times, only difference it disappears more quickly once I get up and start moving.
Maria :(

Both might be helped by getting up and moving around.
See if a hot shower will relieve some of the pressure.
Sinus headaches will also last quite a bit longer than clusters would but you would be able to treat the pain much more easily. I'd take the test here. if you're experiencing both, it may be a little difficult to distinguish but the cluster traits should still stand out for the rest.

on 02/14/04 at 22:45:32, maria9 wrote:

If you have a sinus headache why can't the darn thing be on the opposite side of what you would expect?

Maria :(

I would expect a sinus headache to be more centrally located although it could be triggering activity along the normal paths your clusters might take.

If you mean that these headaches are on a different side than your clusters used to be on, it could be they've switched sides. Not all as uncommon as people think.

good luck
PF

Title: Re: Help, sinus headaches or CH?
Post by t_h_b on Feb 15^th, 2004, 8:02am

Ditto what Pinkfloyd said, plus a sinus headache doesn't normally cause burning, stabbing eye pain--it's more throbbing than stabbing. You're definitely not having shadows??

Good thing is, if you have a sinus infection, antibiotics should help take care of it.

Your MD can also irrigate your sinuses with saline but that is something to avoid except as a last resort. Best advice a doctor ever gave me about sinus infections was to take a hot steamy shower and after the steam starts loosening things up, cup your hands, snort the hot water, then blow it out one side at a time. It's like a self-irrigation without the salt. It still stings a little but doing that and taking pseudoephedrine HCL/Sudafed kept me away from doctors for sinus problems after that.

Title: Re: Help, sinus headaches or CH?
Post by ave on Feb 15^th, 2004, 11:06am

Maria,

it is not very important, but nerve cells have been shown to have a sort of "memory".
It would not be too wild to state that once your nerve cells got "used" to cluster pain, they'd remember. Next time something vaguely familiar cane along they woul;d remember and spring to attention, to hurt like old times.

I myself find that pains caused by something mechanical (like hair grips sitting there too long) will give me a few stabs of the same pain that is part of my cluster arsenal.
It just stops very soon.

So it might be your sinuses misbehaving, calls fort the cluster pain cells.
Of course it is always possible you are having clusters back again... Can't see that from here.

And the shorting of warm water, yes I do that too for my sinuses, but always with a little salt. I bought an eyedropper and that makes it even easier.

Title: Re: Help, sinus headaches or CH?
Post by maria9 on Feb 15^th, 2004, 11:08pm

Well, I definately had a cluster headache today, no mistaking this from a sinus headache. I don't know if I am heading into another cycle or not, but time will tell. My 17 year old son came home tonight and heard that I was not feeling well, found me, gave me a big hug, and said "mom, why don't you just go to bed everything will be better in the morning." Normally, this is good advice. I didn't have the heart to tell him that with clusters, you dread going to bed at night and in the morning you probably feel shittier than when you when to bed. :(

Maria

Title: Re: Help, sinus headaches or CH?
Post by LSUnut on Feb 16^th, 2004, 12:02am

Quote:

Almost two weeks ago I got a bad cold which has turned into a ear infection and possibly a sinus infection. Damn, if the sinus headache does not feel like a CH at times

Sounds very similar to my intro into CH's. I've always suffered from sinus HA's for as long as I can remember and if somebody within 100 miles sneezes, I get a cold. But, one day the sinus infection progressed into my ear and then the party really began (right-sided CH sufferer, same side as the ear infection). My neuro actually thinks that the infecton may have caused nerve damage, although he's never been able to find it on CT or MRI. It was very hard for the docs to diagnose CH because of my very long and involved sinus history. Since the ear infection, I get regular episodic CH's, usually in the fall, as well as, getting them as a prelude to sinus infections. The pain and symptoms involved between the two HA's are very different as PF mentioned (you can tell the difference). Sinus HA's are tolerable (even welcome) compared to the CH pain. The CH's are a bit more severe when coupled to a sinus HA, however. During a normal CH my eye waters and my cheek and ear get flushed, but when there is sinus pressure present, I actually have visual disturbances in my right eye from the extreme pressure.
Quote:

If you have a sinus headache why can't the darn thing be on the opposite side of what you would expect?

I've also noticed that since the CH's began, almost all of my head pain, CH or sinus, is reffered to the right side. I've read so many posts from people with sinus problems, allergies, infections, polyps, etc... it's hard to believe that sinus problems aren't considered one of the major factors leading to CH and that docs would't be more aware of the connection and able to make a faster diagnosis. CH is thought to have numerous etiologies (that's what docs say when they don't know wtf is going on), but it seems to me that the sinus linkage has become common enough that it should always be considered when new CH patients surface. [smiley=huh.gif]

Title: Re: Help, sinus headaches or CH?
Post by maria9 on Feb 17^th, 2004, 5:14pm

Thanks for all of your replies,

As I never have had a sinus infection before I just wasn't quite sure what to expect and what was a sinus vs cluster headache.

Well after having 3 headaches during the day yesterday and 9 (yes 9 at night) all lasting only about 10 minutes, I went back to the Dr. today and her diagnosis was cluster headaches triggered by sinusitis. Her opinion was that the headaches I reported were too short of duration to be sinus related and the frequency was more like a CH. Although the headaches felt like a CH (pain mostly behind the right eye) they were not as intense and did not last as long as a usual CH would for me (30 min). So I guess this means I have started another cycle, does this mean when the sinusitis clears up the CH goes away?

Interesting to note, the last cycle I had 4 years ago came on suddenly as well the day that I had major surgery and was very anemic. Wiley little beast isn't he? He worms his way back into your system when your immune system is lowered as well as attacking people while they are sleeping.

Maria

Title: Re: Help, sinus headaches or CH?
Post by Prense on Feb 17^th, 2004, 7:53pm

on 02/17/04 at 17:14:47, maria9 wrote:

Well after having 3 headaches during the day yesterday and 9 (yes 9 at night) all lasting only about 10 minutes,

CPH?

Hrmmm....

Title: Re: Help, sinus headaches or CH?
Post by pubgirl on Feb 17^th, 2004, 9:02pm

Prense. I agree! Kind of proves a point made elsewhere.

Maria

Although I am sure my last CH cycle was triggered by a nasty sinus infection, the frequency and duration of your attacks does suggest PH or CPH , paroxysmal hemicrania/chronic paroxysmal hemicrania.

Has your doctor tried you on Indomethacin at all?
It is almost completely effective for CPH, and is often used by GP's to rule CPH out before diagnosing CH.

Wendy

Title: Re: Help, sinus headaches or CH?
Post by pubgirl on Feb 17^th, 2004, 9:05pm

Paroxysmal hemicrania (PH), like Cluster Headache (CH), is characterised by being normaly strictly unilateral, short, excruciating headaches that occur in association with cranial autonomic features. PH differs from CH mainly in the higher frequency and shorter duration of individual attacks, though there is a considerable overlap in these characteristics. However, unlike CH, PH responds in dramatic and absolute fashion to indomethacin, thereby underlining the importance of distinguishing it from CH. The attack profile of PH is highly characteristic. The headache is strictly unilateral. The pain is most often centred on the ocular, temporal, maxillary, or frontal regions; less often, the pain is centred on the neck, occiput or the retro-orbital regions. The pain is typically excruciating in severity and described as a throbbing, aching or boring sensation. The headache usually lasts 10–30 minutes, but can range from 2–45 minutes. It has an abrupt onset and cessation. Photophobia and nausea may accompany some attacks though vomiting and phonophobia are rare. During episodes of pain, some sufferers prefer to sit or lie still while the others pace about constantly. In PH the individual attacks occur at a high frequency. Typically, patients have more than five attacks daily though the frequency of attacks shows a considerable fluctuation, ranging from 1–40 daily.

A good clinical history by your GP or a detailed examination by a Neurologist and then a therapeutic trial of indomethacin are all that are necessary to make a diagnosis of PH. As a relatively high number of symptomatic cases have been reported, an MRI scan of the brain should be routinely performed in all patients with PH. The therapeutic trial of oral indomethacin should be initiated at 25 mg three times daily; if there is no or a partial response after 10 days, the dose should be increased to 50 mg three times daily for at least 10 days; if the index of suspicion is high then the dose should be further increased to 75 mg three times daily for 10 days.

Complete resolution of the headache with an appropriate dose of indomethacin is prompt, usually within 1–2 days of the effective dose. The typical maintenance dose ranges from 25–100 mg daily, but doses up to 300 mg daily are occasionally required. Skipping or even delaying doses may result in the prompt reoccurrence of the headache. In patients with EPH, indomethacin should be given for slightly longer than the typical headache bout and then gradually tapered. In patients with CPH, long term treatment is usually necessary; however, long lasting remissions have been reported in rare patients following cessation of indomethacin, hence drug withdrawal should be advised at least once every six months. Gastrointestinal side effects secondary to indomethacin may be treated with antacids, misoprostol, histamine H2 receptor antagonists, or proton pump inhibitors and should always be considered for patients who require long term treatment. The mechanism behind the absolute responsiveness to indomethacin is unknown. It appears to be independent of indomethacin’s effect on prostaglandin synthesis, since other NSAIDs have little or no effect on PH. For patients who cannot tolerate indomethacin one faces a difficult challenge. No other treatment is as consistently effective. We, and others, have tried COX-2 inhibitors and verapamil with limited success

Sources: P.J Goadsby, M .Matharu (et al) - Journal of Neurology, Neurosurgery & Psychiatry

Title: Re: Help, sinus headaches or CH?
Post by maria9 on Feb 17^th, 2004, 10:09pm

Hi Prense and Pubgirl,

Normally a CH would last 30 minutes for me, this cycle started much differently than others, I guess since it was triggered by the sinusitis. The frequency of the HA has been much more than usual especially for the night time and the duration of the ones noted about are much shorter than usual. A 30 minute duration CH could still qualify as CPH, however many years ago Indomethacin was one of the many preventatives I did try unsuccessfully. I guess it wouldn't hurt to try it again as it has been many years and who knows if they had the right dosage then.

This cycle is ramping up quickly as I am now up to 25 minutes per headache and have no doubt at all that these are CH and not just a sinus headache. I think it is to be expected that the pain level will be worse when you add a CH on top of sinusitis. I had forgotten how painful these were and am not used to having this level of pain this early in the cycle.

Thanks,
Maria

Title: Re: Help, sinus headaches or CH?
Post by pubgirl on Feb 17^th, 2004, 10:17pm

Poor you Maria. I am so sorry, that horrible feeling "Oh Shit, there she blows!" when you know they are here.

I base this on no medical evidence whatsoever but I'm sure the pressure I got from the sinus infection caused some kind of reaction in the old trigeminal nerve and set my last cycle off.
Probably a coincidence, but a coincidence that seems to occur a lot with CH sufferers!

If indomethacin doesn't work for you, it is VERY unlikely to be CPH as it is an almost 100% effective treatment for CPH, and anecdotally, not much bloody use for CH at all.

Wishing you a short and manageable cycle

Wendy

Title: Re: Help, sinus headaches or CH?
Post by maria9 on Feb 17^th, 2004, 11:07pm

Thanks Wendy,

I was not aware that sinus problems could trigger a cluster cycle (now I painfully am). It is interesting that something other than the hypothalamus could trigger a cycle. I had none of the usual percursor symptoms of a cycle and the headaches that I naively believed to be sinus related actually started the day the sinusitis started. Now I know they were not sinus headaches but the beginning of the cluster cycle.

Maria

Title: Re: Help, sinus headaches or CH?
Post by Opus on Feb 18^th, 2004, 10:52pm

Watch those sinuses,
Last year my CH switched sides from left to the right. My sinus pain is always on the left. I got my normal CH's under control with melatonion but then I started getting sinus pain, and then the sinus's started triggering right sided CH's. I thought I was going crazy, so I started treating my sinuses aggressively and now I am back to the left side shadows. The right side attacks were just like clusters except my abortive and preventative had NO effect. I believe it was because it was a trigger and not a timed one.

Opus/Paul