The Experts below are selected from a list of 303 Experts worldwide ranked by ideXlab platform
Curtis P. Schreiber - One of the best experts on this subject based on the ideXlab platform.
-
Sinus problems as a cause of Headache refractoriness and migraine chronification.
Current pain and headache reports, 2009Co-Authors: Roger K. Cady, Curtis P. SchreiberAbstract:Sinus Headache is not a diagnostic term supported by the academia, yet it appears to be understood by the general public and larger medical community. It can be considered both a primary and secondary Headache disorder. As a primary Headache disorder, most of the patients considered to have Sinus Headache indeed have migraine (migraine with Sinus symptoms). Yet it is also possible that some attacks of Sinus Headache may represent a unique clinical phenotype of migraine or be a unique clinical entity. Potentially, primary Sinus Headache can chronify and be refractory through immune-mediated mechanisms or as a catalyst for migraine chronification through ineffective treatment or medication overuse and misuse. As a secondary Headache disorder, Sinus Headache can be associated with a wide range of underlying etiologies such as infection, anatomical abnormalities, trauma, and immunological disease or sleep disorders. It is possible that these underlying pathophysiological processes generate long-standing activation of nociceptive mechanisms involved in Headache and can lead to chronification and refractoriness of the Headache symptomatology. This article explores some of the potential mechanisms and the available scientific studies that may explain how Sinus Headache can become chronic and present to the clinician as a refractory Headache disorder.
-
An otolaryngology, neurology, allergy, and primary care consensus on diagnosis and treatment of Sinus Headache.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2006Co-Authors: Howard L. Levine, Curtis P. Schreiber, Michael Setzen, Roger K. Cady, David W. Dodick, Eric J. Eross, Harvey Blumenthal, William R. Lumry, Gary Berman, Paul L. DurhamAbstract:While "Sinus" Headache is a widely accepted clinical diagnosis, many medical specialists consider it to be an uncommon cause of recurrent Headaches. Unnecessary diagnostic studies, surgical interventions, and medical treatments are often the result of the inappropriate diagnosis of Sinus Headache. Both the International Headache Society and the American Academy of Otolaryngology-Head and Neck Surgery have attempted to characterize conditions leading to Headaches of rhinogenic origin. However, they have done so from different perspectives and in isolation from the other specialty groups. An interdisciplinary ad hoc committee recently convened to discuss the role of Sinus disease and the nose in the etiology of Headache and to review recent epidemiologic studies suggesting that Sinus Headache (Headache of rhinogenic origin) and migraine are frequently confused with one another. Clinical trial data are presented which clearly indicate that the majority of Sinus Headaches can actually be classified as migraines. This committee reviewed scientific evidence available from multiple disciplines and concludes that considerable research and clinical study are needed to further understand and explain the role of nasal pathology and autonomic activation in migraine and Headaches of rhinogenic origin. However, there was a consensus from this group that greater diagnostic and therapeutic attention needs to be given to patients complaining of Sinus Headache that may indeed be due to the nose.
-
Sinus Headache migraine and the otolaryngologist
Otolaryngology-Head and Neck Surgery, 2005Co-Authors: Mark E. Mehle, Curtis P. SchreiberAbstract:“Sinus Headache” is a common complaint in the otolaryngology office. Recent literature has shown that the majority of patients with this complaint satisfy the diagnostic criteria for migraine. This review article presents an overview of the Sinus Headache literature, with emphasis on the incidence, identification, and treatment of migraine Headache for the otolaryngologist.
-
Sinus Headache, Migraine, and the Otolaryngologist - Sinus Headache, migraine, and the otolaryngologist.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2005Co-Authors: Mark E. Mehle, Curtis P. SchreiberAbstract:“Sinus Headache” is a common complaint in the otolaryngology office. Recent literature has shown that the majority of patients with this complaint satisfy the diagnostic criteria for migraine. This review article presents an overview of the Sinus Headache literature, with emphasis on the incidence, identification, and treatment of migraine Headache for the otolaryngologist.
-
Sinus Headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment.
Mayo Clinic proceedings, 2005Co-Authors: Roger K. Cady, Curtis P. Schreiber, Michael Setzen, Howard L. Levine, David W. Dodick, Eric J. Eross, Harvey Blumenthal, William R. Lumry, Gary Berman, Paul L. DurhamAbstract:Sinus Headache is a widely accepted clinical diagnosis, although many medical specialists consider it an uncommon cause of recurrent Headaches. The inappropriate diagnosis of Sinus Headache can lead to unnecessary diagnostic studies, surgical interventions, and medical treatments. Both the International Headache Society and the American Academy of Otolaryngology-Head and Neck Surgery have attempted to define conditions that lead to Headaches of rhinogenic origin but have done so from different perspectives and in isolation of each other. An interdisciplinary ad hoc committee convened to discuss the role of Sinus disease as a cause of Headache and to review recent epidemiological studies that suggest Sinus Headache (Headache of rhinogenic origin) and migraine are frequently confused with one another. This committee reviewed available scientific evidence from multiple disciplines and concluded that considerable research and clinical study are required to further understand and delineate the role of nasal pathology and autonomic activation in migraine and Headaches of rhinogenic origin. However, this group agreed that greater diagnostic and therapeutic attention needs to be given to patients with Sinus Headaches.
Michael Ames - One of the best experts on this subject based on the ideXlab platform.
-
Efficacy of Sumatriptan Tablets in Migraineurs Self-Described or Physician-Diagnosed as Having Sinus Headache: A Randomized, Double-Blind, Placebo-Controlled Study
Clinical therapeutics, 2007Co-Authors: Gary Ishkanian, Harvey Blumenthal, Christopher J. Webster, Mary S. Richardson, Michael AmesAbstract:Many patients and physicians interpret episodic Headache in the presence or absence of nasal symptoms as "Sinus' Headache, while ignoring the possible diagnosis of migraine. The purpose of this study was to assess the efficacy and tolerability of sumatriptan succinate 50-mg tablets in patients with migraine presenting with "Sinus" Headache. A randomized, double-blind, placebo-controlled, multicenter study was conducted in adult (aged 18-65 years) migraine patients presenting with self-described or physician-diagnosed "Sinus" Headache. From November 2001 to March 2002, patients meeting International Headache Society criteria for migraine (with > or =2 of the following: unilateral location, pulsating quality, moderate or severe intensity, aggravation by moderate physical activity; and > or =1 of: phonophobia and phonophobia, nausea and/or vomiting) and with no evidence of bacterial rhinoSinusitis were enrolled and randomized in a 1:1 ratio via computer-generated randomization schedule to receive either 1 sumatriptan 50-mg tablet or matching placebo tablet. The primary efficacy end point was Headache response (moderate or severe Headache pain reduced to mild or no Headache pain) at 2 hours after administration. The presence or absence of migraine-associated symptoms and Sinus and nasal symptoms was also measured. Tolerability was assessed through patient-reported adverse events (AEs). Two hundred sixteen patients with self-described or physician-diagnosed "Sinus" Headache received a migraine diagnosis and treated 1 migraine attack with sumatriptan 50 mg. The efficacy (intent-to-treat) analysis included 215 patients treated with sumatriptan 50 mg (n = 108; mean [SD] age, 39.6 [12.3] years; mean [SD] weight, 77.7 [17.7] kg; sex, 71% female; race, 69% white) or placebo (n = 107; mean [SD] age, 41.0 [11.3] years; mean [SD] weight 80.7 [20.9] kg; sex, 69% female; race, 64% white). Significantly more patients treated with sumatriptan 50 mg achieved a positive Headache response at 2 and 4 hours after administration compared with those treated with placebo (69% vs 43% at 2 hours and 76% vs 49% at 4 hours, respectively; both, P < 0.001). Significantly more sumatriptan-treated patients were free from Sinus pain compared with placebo recipients at 2 hours (63% vs 49% placebo, P = 0.049) and 4 hours (77% vs 55%, P = 0.001). All treatments were generally well tolerated. The most common drug-related AEs reported in the sumatriptan and placebo groups, respectively, were dizziness (5% vs < 1%), nausea (3% vs 2%), other pressure/tightness (defined as sense of heaviness; heaviness of upper body, upper extremities; jaw tension; neck tension) (4% vs 0%), and temperature sensations (defined as warm feeling of back of neck, or flushing) (2% vs 0%). No patients experienced any serious AEs. Sumatriptan 50-mg tablets were effective and generally well tolerated in the treatment of these patients presenting with migraine Headaches that were self-described or physician-diagnosed as Sinus Headaches.
-
efficacy of sumatriptan tablets in migraineurs self described or physician diagnosed as having Sinus Headache a randomized double blind placebo controlled study
Clinical Therapeutics, 2007Co-Authors: Gary Ishkanian, Harvey Blumenthal, Christopher J. Webster, Mary S. Richardson, Michael AmesAbstract:Abstract Background: Many patients and physicians interpret episodic Headache in the presence or absence of nasal symptoms as "Sinus' Headache, while ignoring the possible diagnosis of migraine. Objective: The purpose of this study was to assess the efficacy and tolerability of sumatriptan succinate 50-mg tablets in patients with migraine presenting with "Sinus" Headache. Methods: A randomized, double-blind, placebo-controlled, multicenter study was conducted in adult (aged 18–65 years) migraine patients presenting with self-described or physician-diagnosed "Sinus" Headache. From November 2001 to March 2002, patients meeting International Headache Society criteria for migraine (with ≥2 of the following: unilateral location, pulsating quality, moderate or severe intensity, aggravation by moderate physical activity; and ≥1 of: phonophobia and phonophobia, nausea and/or vomiting) and with no evidence of bacterial rhinoSinusitis were enrolled and randomized in a 1:1 ratio via computer-generated randomization schedule to receive either 1 sumatriptan 50-mg tablet or matching placebo tablet. The primary efficacy end point was Headache response (moderate or severe Headache pain reduced to mild or no Headache pain) at 2 hours after administration. The presence or absence of migraine-associated symptoms and Sinus and nasal symptoms was also measured. Tolerability was assessed through patient-reported adverse events (AEs). Results: Two hundred sixteen patients with self-described or physician-diagnosed "Sinus" Headache received a migraine diagnosis and treated 1 migraine attack with sumatriptan 50 mg. The efficacy (intentto-treat) analysis included 215 patients treated with sumatriptan 50 mg (n = 108; mean [SD] age, 39.6 [12.3] years; mean [SD] weight, 77.7 [17.7] kg; sex, 71% female; race, 69% white) or placebo (n = 107; mean [SD] age, 41.0 [11.3] years; mean [SD] weight 80.7 [20.9] kg; sex, 69% female; race, 64% white). Significantly more patients treated with sumatriptan 50 mg achieved a positive Headache response at 2 and 4 hours after administration compared with those treated with placebo (69% vs 43% at 2 hours and 76% vs 49% at 4 hours, respectively; both, P P = 0.049) and 4 hours (77% vs 55%, P = 0.001). All treatments were generally well tolerated. The most common drug-related AEs reported in the sumatriptan and placebo groups, respectively, were dizziness (5% vs Conclusions: Sumatriptan 50-mg tablets were effective and generally well tolerated in the treatment of these patients presenting with migraine Headaches that were self-described or physician-diagnosed as Sinus Headaches.
-
Prevalence of migraine in patients with a history of self-reported or physician-diagnosed "Sinus" Headache.
Archives of internal medicine, 2004Co-Authors: Curtis P. Schreiber, Susan Hutchinson, Christopher J. Webster, Michael Ames, Mary S. Richardson, Connie PowersAbstract:Background Symptoms referable to the Sinus area are frequently reported during migraine attacks, but are not recognized in diagnostic criteria. Underrecognition of migraine may be partly attributed to a variable clinical presentation, and migraines with "Sinus" symptoms contribute to this problem. This study was conducted to determine the prevalence of migraine-type Headache (International Headache Society [IHS]–defined migraine without aura [IHS 1.1], migraine with aura [IHS 1.2], or migrainous disorder [IHS 1.7]) in patients with a history of self-described or physician-diagnosed "Sinus" Headache. Methods During a clinic visit, patients with a history of "Sinus" Headache, no previous diagnosis of migraine, and no evidence of infection were assigned an IHS Headache diagnosis on the basis of Headache histories and reported symptoms. Results A total of 2991 patients were screened. The majority (88%) of these patients with a history of self-described or physician-diagnosed "Sinus" Headache were diagnosed at the screening visit as fulfilling IHS migraine criteria (80% of patients) or migrainous criteria (8% of patients). The most common symptoms referable to the Sinus area reported by patients at screening were Sinus pressure (84%), Sinus pain (82%), and nasal congestion (63%). Conclusions In this study, 88% of patients with a history of "Sinus" Headache were determined to have migraine-type Headache. In patients with recurrent Headaches without fever or purulent discharge, the presence of Sinus-area symptoms may be part of the migraine process. Migraine should be included in the differential diagnosis of these patients.
Roger K. Cady - One of the best experts on this subject based on the ideXlab platform.
-
Sinus problems as a cause of Headache refractoriness and migraine chronification.
Current pain and headache reports, 2009Co-Authors: Roger K. Cady, Curtis P. SchreiberAbstract:Sinus Headache is not a diagnostic term supported by the academia, yet it appears to be understood by the general public and larger medical community. It can be considered both a primary and secondary Headache disorder. As a primary Headache disorder, most of the patients considered to have Sinus Headache indeed have migraine (migraine with Sinus symptoms). Yet it is also possible that some attacks of Sinus Headache may represent a unique clinical phenotype of migraine or be a unique clinical entity. Potentially, primary Sinus Headache can chronify and be refractory through immune-mediated mechanisms or as a catalyst for migraine chronification through ineffective treatment or medication overuse and misuse. As a secondary Headache disorder, Sinus Headache can be associated with a wide range of underlying etiologies such as infection, anatomical abnormalities, trauma, and immunological disease or sleep disorders. It is possible that these underlying pathophysiological processes generate long-standing activation of nociceptive mechanisms involved in Headache and can lead to chronification and refractoriness of the Headache symptomatology. This article explores some of the potential mechanisms and the available scientific studies that may explain how Sinus Headache can become chronic and present to the clinician as a refractory Headache disorder.
-
An otolaryngology, neurology, allergy, and primary care consensus on diagnosis and treatment of Sinus Headache.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2006Co-Authors: Howard L. Levine, Curtis P. Schreiber, Michael Setzen, Roger K. Cady, David W. Dodick, Eric J. Eross, Harvey Blumenthal, William R. Lumry, Gary Berman, Paul L. DurhamAbstract:While "Sinus" Headache is a widely accepted clinical diagnosis, many medical specialists consider it to be an uncommon cause of recurrent Headaches. Unnecessary diagnostic studies, surgical interventions, and medical treatments are often the result of the inappropriate diagnosis of Sinus Headache. Both the International Headache Society and the American Academy of Otolaryngology-Head and Neck Surgery have attempted to characterize conditions leading to Headaches of rhinogenic origin. However, they have done so from different perspectives and in isolation from the other specialty groups. An interdisciplinary ad hoc committee recently convened to discuss the role of Sinus disease and the nose in the etiology of Headache and to review recent epidemiologic studies suggesting that Sinus Headache (Headache of rhinogenic origin) and migraine are frequently confused with one another. Clinical trial data are presented which clearly indicate that the majority of Sinus Headaches can actually be classified as migraines. This committee reviewed scientific evidence available from multiple disciplines and concludes that considerable research and clinical study are needed to further understand and explain the role of nasal pathology and autonomic activation in migraine and Headaches of rhinogenic origin. However, there was a consensus from this group that greater diagnostic and therapeutic attention needs to be given to patients complaining of Sinus Headache that may indeed be due to the nose.
-
Salivary levels of CGRP and VIP in rhinoSinusitis and migraine patients.
Headache, 2006Co-Authors: Jaime L. Bellamy, Roger K. Cady, Paul L. DurhamAbstract:Secretion of calcitonin gene-related peptide (CGRP) from trigeminal nerves and vasoactive intestinal peptide (VIP) from parasympathetic nerves is involved in the pathophysiology of migraine and rhinoSinusitis. Analysis of these neuropeptides in human saliva samples can be used as markers of trigeminal and parasympathetic nerve activity in patients between and during attacks as well as in response to specific treatments. To compare the amount of trigeminal sensory and parasympathetic nerve activation by measuring CGRP and VIP levels in the saliva of subjects experiencing noninfectious allergic rhinoSinusitis, migraine with Sinus symptoms, and no symptoms. Subjects were enrolled in three groups. Group A: subjects without a history of migraine, "Sinus" Headache, or allergic rhinoSinusitis within the previous 6 months. Group B: subjects with chronic recurrent noninfectious rhinoSinusitis and no history of migraine or "Sinus" Headache. Group C: subjects with self-described "Sinus" Headaches whose symptoms met International Headache Society diagnostic criteria (1.1 or 1.2) for migraine. The total amount of CGRP and VIP present in saliva collected under normal, pathological, and therapeutic conditions was determined by radioimmunoassay. Neuropeptide levels were normalized to total volume and amount of protein, and levels were correlated to onset and change in clinical symptoms. Total volume, total protein, and CGRP and VIP levels did not significantly change in saliva collected on consecutive days in the clinic and at the subject's home, respectively. No appreciable change in baseline salivary levels of CGRP and VIP was detected in control subjects. However, baseline salivary levels of CGRP and VIP were significantly elevated between attacks in allergic rhinoSinusitis and migraine subjects compared to control values. For rhinoSinusitis subjects, the amount of CGRP and VIP during attacks returned to baseline values following treatment with pseudoephedrine and relief of symptoms. Similarly, CGRP and VIP levels during a migraine Headache were significantly reduced within 2 hours after sumatriptan treatment and reported symptom relief. Correlation of CGRP and VIP saliva levels observed in our study supports physiologically coordinated regulation of trigeminal and parasympathetic nerve activation in allergic rhinoSinusitis and migraine patients between and during attacks as well as following treatment. Furthermore, our findings demonstrate that analysis of human saliva neuropeptides may provide a semiquantitative index of pathological and therapeutic states and, therefore, function as a clinical model for studying neuronal mechanisms involved in migraine and rhinoSinusitis.
-
Sinus Headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment.
Mayo Clinic proceedings, 2005Co-Authors: Roger K. Cady, Curtis P. Schreiber, Michael Setzen, Howard L. Levine, David W. Dodick, Eric J. Eross, Harvey Blumenthal, William R. Lumry, Gary Berman, Paul L. DurhamAbstract:Sinus Headache is a widely accepted clinical diagnosis, although many medical specialists consider it an uncommon cause of recurrent Headaches. The inappropriate diagnosis of Sinus Headache can lead to unnecessary diagnostic studies, surgical interventions, and medical treatments. Both the International Headache Society and the American Academy of Otolaryngology-Head and Neck Surgery have attempted to define conditions that lead to Headaches of rhinogenic origin but have done so from different perspectives and in isolation of each other. An interdisciplinary ad hoc committee convened to discuss the role of Sinus disease as a cause of Headache and to review recent epidemiological studies that suggest Sinus Headache (Headache of rhinogenic origin) and migraine are frequently confused with one another. This committee reviewed available scientific evidence from multiple disciplines and concluded that considerable research and clinical study are required to further understand and delineate the role of nasal pathology and autonomic activation in migraine and Headaches of rhinogenic origin. However, this group agreed that greater diagnostic and therapeutic attention needs to be given to patients with Sinus Headaches.
-
Sinus Headache: a clinical conundrum.
Otolaryngologic clinics of North America, 2004Co-Authors: Roger K. Cady, Curtis P. SchreiberAbstract:The concept of Sinus disease as a common cause of Headache is deeply ingrained in the American public, but there is little evidence to support the Sinuses as a common cause of disabling Headache. On the other hand, a body of evidence supports the concept that migraine can present with facial pain and nasal symptoms such as congestion and rhinorrhea. In clinical studies nearly 90% of participants with self-diagnosed or physician-diagnosed Sinus Headache met criteria for IHS migraine-type Headache and responded to triptan interventions in a manner similar to that witnessed in migraine. Consequently it is likely that most individuals seeking medical attention for Sinus Headache are, in fact, experiencing migraine. Nasal pathologic conditions, however, can also cause Sinus Headache. In general. other symptoms in addition to Headache are also present, but there is clear symptom overlap among migraine, rhinoSinusitis, and other nasal passage/Sinus pathologic conditions, and further research is needed.
Mark E. Mehle - One of the best experts on this subject based on the ideXlab platform.
-
What Do We Know About Rhinogenic Headache
Otolaryngologic clinics of North America, 2014Co-Authors: Mark E. MehleAbstract:Sinus Headache is a common presenting complaint in the otolaryngology office. Although most patients with this presentation are found to have migraine Headache, many do not, and others fail therapy. This review focuses on the current understanding of nonneoplastic rhinogenic Headache: Headaches that are caused or exacerbated by nasal or paranasal Sinus disease or anatomy. The literature regarding this topic is reviewed, along with a review of surgical series seeking to correct these abnormalities and the outcomes obtained with intervention. Suggestions are provided regarding patient diagnosis and management, and options for intervention are reviewed.
-
Migraine and Allergy: A Review and Clinical Update
Current Allergy and Asthma Reports, 2012Co-Authors: Mark E. MehleAbstract:Migraine and allergy are both common diseases. Many patients suffer from both, and the vast majority of patients with “Sinus Headache” complaints are found to have migraine, making migraine identification important to allergists. This review addresses the possibility that allergy and migraine are comorbid conditions, focusing on epidemiology, shared biochemical pathways, and underlying mechanisms. Therapeutic implications of this possible relationship have been the subject of several recent studies, making a review of this association timely and prudent.
-
Sinus CT scan findings in "Sinus Headache" migraineurs.
Headache, 2008Co-Authors: Mark E. Mehle, Patricia S. KremerAbstract:Objective.— To evaluate the Sinus CT scan findings in “Sinus Headache” migraineurs, and to compare the findings to nonmigraine “Sinus Headache” patients. Background.— The majority of patients presenting with “Sinus Headache” satisfy the International Headache Society (IHS) criteria for migraine Headache. Few studies have correlated the rhinologic complaints and computed tomography (CT) findings in these patients. Methods.— Thirty-five patients with “Sinus Headache” were evaluated prospectively and referred for CT of the paranasal Sinuses. The CT scans were assessed for Sinus abnormality (recorded as a Lund–Mackay [L-M] score) and were analyzed for concha bullosa and septal deviation. The findings in the migraine cohort were compared with the nonmigraine “Sinus Headache” patients. Findings.— Twenty-six patients (74.3%) satisfied the IHS criteria for migraine. The mean CT scan L-M score did not differ significantly between the migraine (2.07) and nonmigraine cohort (2.66). Five of the migraine group had substantial Sinus disease radiographically (with L-M scores of 5 or above). Concha bullosa of at least 1 middle turbinate was more common in the nonmigraine cohort. An analysis of the sidedness of the Headaches, Sinus disease, concha bullosa, and/or septal deviation is presented. Conclusions.— The majority of “Sinus Headache” patients satisfy the IHS criteria for migraine. Surprisingly, these patients often have radiographic Sinus disease. This raises the possibility of selection bias in otolaryngology patients, inaccurate diagnosis, or radiographic Sinus disease and migraine as comorbid conditions. Positive migraine histories apparently do not obviate the need for a thorough ENT workup, possibly including CT scanning.
-
Sinus Headache migraine and the otolaryngologist
Otolaryngology-Head and Neck Surgery, 2005Co-Authors: Mark E. Mehle, Curtis P. SchreiberAbstract:“Sinus Headache” is a common complaint in the otolaryngology office. Recent literature has shown that the majority of patients with this complaint satisfy the diagnostic criteria for migraine. This review article presents an overview of the Sinus Headache literature, with emphasis on the incidence, identification, and treatment of migraine Headache for the otolaryngologist.
-
Sinus Headache, Migraine, and the Otolaryngologist - Sinus Headache, migraine, and the otolaryngologist.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2005Co-Authors: Mark E. Mehle, Curtis P. SchreiberAbstract:“Sinus Headache” is a common complaint in the otolaryngology office. Recent literature has shown that the majority of patients with this complaint satisfy the diagnostic criteria for migraine. This review article presents an overview of the Sinus Headache literature, with emphasis on the incidence, identification, and treatment of migraine Headache for the otolaryngologist.
Harvey Blumenthal - One of the best experts on this subject based on the ideXlab platform.
-
efficacy of sumatriptan tablets in migraineurs self described or physician diagnosed as having Sinus Headache a randomized double blind placebo controlled study
Clinical Therapeutics, 2007Co-Authors: Gary Ishkanian, Harvey Blumenthal, Christopher J. Webster, Mary S. Richardson, Michael AmesAbstract:Abstract Background: Many patients and physicians interpret episodic Headache in the presence or absence of nasal symptoms as "Sinus' Headache, while ignoring the possible diagnosis of migraine. Objective: The purpose of this study was to assess the efficacy and tolerability of sumatriptan succinate 50-mg tablets in patients with migraine presenting with "Sinus" Headache. Methods: A randomized, double-blind, placebo-controlled, multicenter study was conducted in adult (aged 18–65 years) migraine patients presenting with self-described or physician-diagnosed "Sinus" Headache. From November 2001 to March 2002, patients meeting International Headache Society criteria for migraine (with ≥2 of the following: unilateral location, pulsating quality, moderate or severe intensity, aggravation by moderate physical activity; and ≥1 of: phonophobia and phonophobia, nausea and/or vomiting) and with no evidence of bacterial rhinoSinusitis were enrolled and randomized in a 1:1 ratio via computer-generated randomization schedule to receive either 1 sumatriptan 50-mg tablet or matching placebo tablet. The primary efficacy end point was Headache response (moderate or severe Headache pain reduced to mild or no Headache pain) at 2 hours after administration. The presence or absence of migraine-associated symptoms and Sinus and nasal symptoms was also measured. Tolerability was assessed through patient-reported adverse events (AEs). Results: Two hundred sixteen patients with self-described or physician-diagnosed "Sinus" Headache received a migraine diagnosis and treated 1 migraine attack with sumatriptan 50 mg. The efficacy (intentto-treat) analysis included 215 patients treated with sumatriptan 50 mg (n = 108; mean [SD] age, 39.6 [12.3] years; mean [SD] weight, 77.7 [17.7] kg; sex, 71% female; race, 69% white) or placebo (n = 107; mean [SD] age, 41.0 [11.3] years; mean [SD] weight 80.7 [20.9] kg; sex, 69% female; race, 64% white). Significantly more patients treated with sumatriptan 50 mg achieved a positive Headache response at 2 and 4 hours after administration compared with those treated with placebo (69% vs 43% at 2 hours and 76% vs 49% at 4 hours, respectively; both, P P = 0.049) and 4 hours (77% vs 55%, P = 0.001). All treatments were generally well tolerated. The most common drug-related AEs reported in the sumatriptan and placebo groups, respectively, were dizziness (5% vs Conclusions: Sumatriptan 50-mg tablets were effective and generally well tolerated in the treatment of these patients presenting with migraine Headaches that were self-described or physician-diagnosed as Sinus Headaches.
-
Efficacy of Sumatriptan Tablets in Migraineurs Self-Described or Physician-Diagnosed as Having Sinus Headache: A Randomized, Double-Blind, Placebo-Controlled Study
Clinical therapeutics, 2007Co-Authors: Gary Ishkanian, Harvey Blumenthal, Christopher J. Webster, Mary S. Richardson, Michael AmesAbstract:Many patients and physicians interpret episodic Headache in the presence or absence of nasal symptoms as "Sinus' Headache, while ignoring the possible diagnosis of migraine. The purpose of this study was to assess the efficacy and tolerability of sumatriptan succinate 50-mg tablets in patients with migraine presenting with "Sinus" Headache. A randomized, double-blind, placebo-controlled, multicenter study was conducted in adult (aged 18-65 years) migraine patients presenting with self-described or physician-diagnosed "Sinus" Headache. From November 2001 to March 2002, patients meeting International Headache Society criteria for migraine (with > or =2 of the following: unilateral location, pulsating quality, moderate or severe intensity, aggravation by moderate physical activity; and > or =1 of: phonophobia and phonophobia, nausea and/or vomiting) and with no evidence of bacterial rhinoSinusitis were enrolled and randomized in a 1:1 ratio via computer-generated randomization schedule to receive either 1 sumatriptan 50-mg tablet or matching placebo tablet. The primary efficacy end point was Headache response (moderate or severe Headache pain reduced to mild or no Headache pain) at 2 hours after administration. The presence or absence of migraine-associated symptoms and Sinus and nasal symptoms was also measured. Tolerability was assessed through patient-reported adverse events (AEs). Two hundred sixteen patients with self-described or physician-diagnosed "Sinus" Headache received a migraine diagnosis and treated 1 migraine attack with sumatriptan 50 mg. The efficacy (intent-to-treat) analysis included 215 patients treated with sumatriptan 50 mg (n = 108; mean [SD] age, 39.6 [12.3] years; mean [SD] weight, 77.7 [17.7] kg; sex, 71% female; race, 69% white) or placebo (n = 107; mean [SD] age, 41.0 [11.3] years; mean [SD] weight 80.7 [20.9] kg; sex, 69% female; race, 64% white). Significantly more patients treated with sumatriptan 50 mg achieved a positive Headache response at 2 and 4 hours after administration compared with those treated with placebo (69% vs 43% at 2 hours and 76% vs 49% at 4 hours, respectively; both, P < 0.001). Significantly more sumatriptan-treated patients were free from Sinus pain compared with placebo recipients at 2 hours (63% vs 49% placebo, P = 0.049) and 4 hours (77% vs 55%, P = 0.001). All treatments were generally well tolerated. The most common drug-related AEs reported in the sumatriptan and placebo groups, respectively, were dizziness (5% vs < 1%), nausea (3% vs 2%), other pressure/tightness (defined as sense of heaviness; heaviness of upper body, upper extremities; jaw tension; neck tension) (4% vs 0%), and temperature sensations (defined as warm feeling of back of neck, or flushing) (2% vs 0%). No patients experienced any serious AEs. Sumatriptan 50-mg tablets were effective and generally well tolerated in the treatment of these patients presenting with migraine Headaches that were self-described or physician-diagnosed as Sinus Headaches.
-
An otolaryngology, neurology, allergy, and primary care consensus on diagnosis and treatment of Sinus Headache.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2006Co-Authors: Howard L. Levine, Curtis P. Schreiber, Michael Setzen, Roger K. Cady, David W. Dodick, Eric J. Eross, Harvey Blumenthal, William R. Lumry, Gary Berman, Paul L. DurhamAbstract:While "Sinus" Headache is a widely accepted clinical diagnosis, many medical specialists consider it to be an uncommon cause of recurrent Headaches. Unnecessary diagnostic studies, surgical interventions, and medical treatments are often the result of the inappropriate diagnosis of Sinus Headache. Both the International Headache Society and the American Academy of Otolaryngology-Head and Neck Surgery have attempted to characterize conditions leading to Headaches of rhinogenic origin. However, they have done so from different perspectives and in isolation from the other specialty groups. An interdisciplinary ad hoc committee recently convened to discuss the role of Sinus disease and the nose in the etiology of Headache and to review recent epidemiologic studies suggesting that Sinus Headache (Headache of rhinogenic origin) and migraine are frequently confused with one another. Clinical trial data are presented which clearly indicate that the majority of Sinus Headaches can actually be classified as migraines. This committee reviewed scientific evidence available from multiple disciplines and concludes that considerable research and clinical study are needed to further understand and explain the role of nasal pathology and autonomic activation in migraine and Headaches of rhinogenic origin. However, there was a consensus from this group that greater diagnostic and therapeutic attention needs to be given to patients complaining of Sinus Headache that may indeed be due to the nose.
-
Sinus Headache: a neurology, otolaryngology, allergy, and primary care consensus on diagnosis and treatment.
Mayo Clinic proceedings, 2005Co-Authors: Roger K. Cady, Curtis P. Schreiber, Michael Setzen, Howard L. Levine, David W. Dodick, Eric J. Eross, Harvey Blumenthal, William R. Lumry, Gary Berman, Paul L. DurhamAbstract:Sinus Headache is a widely accepted clinical diagnosis, although many medical specialists consider it an uncommon cause of recurrent Headaches. The inappropriate diagnosis of Sinus Headache can lead to unnecessary diagnostic studies, surgical interventions, and medical treatments. Both the International Headache Society and the American Academy of Otolaryngology-Head and Neck Surgery have attempted to define conditions that lead to Headaches of rhinogenic origin but have done so from different perspectives and in isolation of each other. An interdisciplinary ad hoc committee convened to discuss the role of Sinus disease as a cause of Headache and to review recent epidemiological studies that suggest Sinus Headache (Headache of rhinogenic origin) and migraine are frequently confused with one another. This committee reviewed available scientific evidence from multiple disciplines and concluded that considerable research and clinical study are required to further understand and delineate the role of nasal pathology and autonomic activation in migraine and Headaches of rhinogenic origin. However, this group agreed that greater diagnostic and therapeutic attention needs to be given to patients with Sinus Headaches.