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Old 02-10-2009, 09:04 PM   #1
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Facial Migraines not Sinus Infection

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Facial Migraines

As I write this page of information on “Facial Migraines” I am in the 7th day in a row of pain and other symptoms. I have what has been described by my ENT specialist as “Facial Migraines”. She told me 85% of all so called “Sinus Headaches” are really migraines. My Neurologist and family doctor has tried to treat them just like any other migraine with no success. The following is what I feel to be very important observations and hypothetical conclusions made by me regarding my illness.

I personally have not done the research proving that changes in “barometric pressure” (here after referred to as “BP”) cause Migraines but it is will documented. My main trigger is “BP” changes. Bright light, especially florescent, is a trigger as will as in smells and loud noises. You can avoid the latter but can’t avoid the “Weather”.

After giving the subject a lot of thought and study (where would we be without the internet?) I have come to what, I believe, are some very important conclusion worthy of more study by the medical community. I have been noting the daily “BP” changes for some time now and there effect on my well being. I have also tried many of the preventative and interrupting medication used for “General Migraine” sufferers. After this the following is my idea of the course of action that should be taken to both prevent and relive the “Facial Migraines” symptoms.

Let me first state that none of the medication from the “Interrupting” class of migraines medication did much to help my symptoms. Medication, like Maxalt & Imitrex and Relpax, are what I am referring to. There of course are many more but I am certain that my solution will not come from theses type of medication.

The preventative medication, of which many come from the “Triptan” family, did not help as well. I in fact developed an elevated heart rate from one of them. It took three months for my heart rate to return to normal after getting off the medication.


Here is my “Hypothesis” regarding the class of migraines known as “Facial Migraines” and the cause and treatment of them. Those of us who get this type of migraines have a very close “sensory” link to the frontal lobe of the brain through the Sinus cavity. In the frontal lobe you will find the “Sensory Receptors” of the brain.

All my life strong perfume would bring on a headache, focused in my forehead. I have had to leave many a “Denny’s Restaurant” for this reason over the years. Office building and other places where they use Fluorescent lighting have also made me sick with Sinus pressure and drainage, similar to an allergy attack. I used to blame the building air-conditioning for harboring mold that caused my problem. When we had an “on-shore” breeze, from an approaching weather front, I thought it was the mold blowing in front the coast making me sick. When we had what locally is called a “Santa-Anna” condition, with high wind blowing form the dessert areas, I again thought of allergies as the cause for my sickness and pain. I know now it was never allergies and in fact I have no allergies.

As I have gotten older the problem has gotten extremely bad. I have many more “bad” days then good. My understanding is with “normal” migraines as you age they lessen in both frequency and severity. Most Doctors believe migraines are vascular in nature and treat them as such. They use medication designed to increase the elasticity of the arteries to help them expand as needed without causing pain. This need for expansion is thought to be caused by a reaction to certain food triggers.

My belief is that the cause of “Facial Migraines” has nothing to do with arteries. They are purely caused by the extremely sensitive sensors located in the frontal lobe of such sufferers. When they are stimulated by a smell, bright light or change in the “BP” this is what might be happening. The pain stimulates the Sinuses which cause them to produce coppice amount of sinus fluid with the intent of cleaning out the offending agent they perceive is the cause. This also is the cause of the “Pressure” most migraine (Esp. Facial) suffers will feel in there head.

With that in mine there should be a variety of way developed to remedy this problem. I currently have only one way to make life bearable and to function somewhat

I take “Vicodin” as sparing as possible and it is effective. It has both “acetaminophen” and “hydrocodone”. The Acetaminophen (Tylenol), in Vicodin, really servers no purpose in the relief I get from its use. It is the Codeine that is the good guy here. It desensitizes the nerve ending to the signals coming form the sinuses and thus provides some relief. This though, hopefully won’t be the only medication or source of relief.

There must be other medication to “desensitize” theses nerves hopefully without bad or nuisance side effects that Vicodin can cause. Also you would think there would be a surgery available to maybe cut the nerves causing this problem. I have heard of a woman who after having a “nose job” no longer had migraines. I must assume she had facial migraines for this to have worked.

This is all I have to say at this time, laughing out loud, and I know it’s a lot. I just hope someone might read this that can make a real difference. Who can find a solution that is not a Band-Aid but a permeate cure. If you have any other information along this mater please post.

Thank You

Last edited by moderator2; 02-11-2009 at 06:13 AM. Reason: please do not post your real name or contact information - use private messaging instead

 
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Old 02-11-2009, 09:09 AM   #2
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Re: Facial Migraines not Sinus Infection

Hi Shurluk, your post is very interesting. I had my first ever migraine a week ago. I currently take ibuprofen 800mg for headaches which I have constantly for bulging disc in my neck, I also get epidurals and trigger point injections. But, when I got this migraine, nothing worked, I had some vicodan from a previous surgery and had never used it, so I took a half of one, it improved just slightly, so next day I took a whole one, no improvement at all, I ended up going to urgent care and getting a shot of toradol (sp?) it took 1 1/2 hours to work, and I also got a prescription of fiorcet, which you have to take it before the migraine gets bad or it won't work at all. Yesterday I got another epidural, I had a horrible headache when I went there, and a horrible headache when I went to recovery, they gave me a shot of toradol, it took another 2 hours to work, but it does work. I know this does not sound like facial migraines. I am curious to know if you ever had one of these shots. Even though they took a while to work, they do help immensely. Be well...

Sunny

 
Old 02-11-2009, 09:19 AM   #3
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Re: Facial Migraines not Sinus Infection

i am just wondering as myself being a lifelong migrane sufferer,that mere fact that none of the 'abortives" have actually worked on you,if this could possibly be something else entirely. I started out on the med called midrin asap as soon an it had been invented as the very first abortive migrane med availiabvle back in like 1981? this drug was an absolute godsend that actually for the first time(in 9 VERY long years),took my normal 12 to up to two day long migranes down to only about 45 minutes. just feaked me out.

just the fact that you have found no relief what so ever ever with these types of meds really makes me wonder just what your true triggers are,or is. do you get that classic migrane 'aura' before your migranes hit,or just the head pain like out of nowhere when it happens? this does matter.

the thing is,migrane is NOT 'just' a vascular type of headache symdrome,there is actually 'something' that triggers that cycle that kicks in the vascular component. it is something in most cases that triggers that chemical to be released within our brains that starts the whole freaking process to begin. this some can be strictly a vascular trigger like whenver i have had to have the five seperate angiograms for my brain anuerysm over the years,EVERY single time they do that very last dye shot that simply overexpands the vessels,it always results in a whopper of a migrane that only midrin itself,not fent or dilaudid or anything else,just only midrin for that particularly triggered migrane will ick it,only midrin. i also have a ton of different food triggers that i have dediced now over the many years since i started getting there at age 13. the very first one i discovered was peanut butter for some insane reson. then italian suasage,then red wineand so on and so on. every silge time i now get one,i think back to what i actually ate the day before,not that particular day,it has to be fromthe day befroe,which l;eads me to thin that some level of metabolization or 'breakdown' has to be taking place with that certain food that ends up being this 'chemical' that just will trigger the syndrome for me. now,since this past year,it is red dye that is my newest trigger.

i really do think that you are onto something there with your own personal triggers being changes in the BP, it would make alot of sense. you simply have to start playing detective when it comes to really defining your own migranes and what will set them off. i really do feel that you are doing the right thing. once i started realizing how many real food triggers were responsible for some of my migranes,the frequecny of them went down dramatically.

the one thing that i personally find very interesting is the fat that your migrnaes actually appear to react at least somewhat to narcotic intervention wghich in most case of tru migrene,just donlt work for anything. have toy EVER in all this time actually had any leavel of brainscan done to jsuts see for vertain that there is not an other more ominous underlying reason for wta you have been clasicfied a having a facial migrnmaes. let me tell ya,there are a tonn of very different types of poroblems you can get within the brain that can give toy the hypersensitivitry to light and sound an alot of othe more sesory problems. but getting an MRI WITH a contrasting agent would really really be a great place to start if you have not yet done so.

the one huge thing i do know about the frontal lobe among other things is this IS where the executiave thinking process is located. my son unfortunetly suffered a very severe brain and skull injury that caused a bleed into his frontal lobe a few yers ago. it did very much so affect his overall decision making capabilities in alot of varying ways.

if you actually did have any level of any type of true brain scan over the years,could you please just let me know and also what any true hard findings showed up in that summary at the end(ad how long ago these were done)? this is very important. i do wish you so much luck in getting these nightmares under some level of real control. plaease,if you can,answer some of the quesrions i asked. it would help me to help you in the very best ways. marcia
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Old 02-11-2009, 11:09 AM   #4
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Re: Facial Migraines not Sinus Infection

No I have not had one of thoses shots but I would like to try them. Did your "Migraine" return after the shot wore off? Thank You

 
Old 02-11-2009, 11:22 AM   #5
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Re: Facial Migraines not Sinus Infection

Quote:
Originally Posted by shurluk View Post
No I have not had one of thoses shots but I would like to try them. Did your "Migraine" return after the shot wore off? Thank You
Hey Shurluk, no, the headache did not come back thank god! And apparently the shot stays in your system for a few days. Also ask about firocet, it is good, but like I said before, you have to take it at the very first sing of a migraine or it won't work. My first signs were sweating profusely and horrible nausea, problem being then, I didn't know as I had not ever had a migraine before.

Sunny

 
Old 02-11-2009, 11:34 AM   #6
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Re: Facial Migraines not Sinus Infection

Thank you for your reply! You reaffirm the truth of what I tell my self when I’m suffering which is “others feel much worse pain then I am experiencing so deal with it”.

My God continually grant you the strength to deal with your pain and that of your loved ones is my prayer for you.

I had a MRI but not with a dye. It did not show anything as we suspected. Reading the post on Ronda’s site about migraines really helped me.

Many migraine suffers have found that “Codeine” help relief some of the pain but not all of it of course. Other migraine suffers find no relief with Vicodin or any other strictly pain medication. Those who Vicodin dose not work for have found relief from one of the many migraine medication it most cases.

My neurological condition does not fit the mold of the vast majority of migraines. This is self evident form the inability of getting relief form the traditional migraine medication. I really feel A form of a nerve block, like they use for back pain, would be helpful. This is just my idea and I’m not a doctor so it may not be at all possible.

Last edited by moderator2; 02-11-2009 at 11:37 AM. Reason: posted disallowed website(s)

 
Old 02-11-2009, 11:44 AM   #7
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Re: Facial Migraines not Sinus Infection

Getting to it fast is a problem for me unfortunately a lot of the time. I also have to many incidences to use the common abortive medication which can’t be taken more then 9 times a month. When a real super BAD one is coming on I believe I do have some warning though. I get very depressed and grumpy for seemly no reason. Last week this was the case. I had a small fight with my wife and was short with one of my daughters. I then felt real tired and lay down and went to sleep. About 2 hours latter I woke up in very server pain of the worst kind. I had been dreaming of being in pain and looking for relief when I woke up. If I realize that is happing again I would like to try a “Maxalt” or other migraine interrupter medication to see it will help. Thank you again for your reply.

 
Old 02-11-2009, 01:02 PM   #8
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Re: Facial Migraines not Sinus Infection

Shurluck, intersting timing on this. I have been posting recently about these headaches I have begun to get. I never had headaches hardly ever. ABout 4 years ago I started to get one it was one of the worst I have ever had but now looking back wasn't so bad. I was lucky it was gone within a week and then it never came back until about a year later. These were bad. Some would hit hard and then be gone the next day, some would be bad enough to effect my day and would stay around 2 weeks. I suffered these on and off for about 3 months, then they went away again. Last year I had a few but not as bad as the previous year.

Now this year they are back with a vengance. I am realizing that they tend to come at the same time of year. I live in central Florida and our weather is usually predictably the same may through october. It's usually Jan - March that they are here and this is when we experience cold fronts and major change in our weather. So I too have wondered if mine were weather related and mine are definately in the face and forehead.

I have tried everything over the counter and nothing worked. I am lucky that when it's get to "almost need to go to ER bad" I have meds I can take. I take 1 and if it hasn't worked I can take another 30 minutes later. That usually works enough for me to fall asleep and pray it won't be there the next day.

Do you think it's the facial migraines?

Melissa

 
Old 02-12-2009, 10:55 AM   #9
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Re: Facial Migraines not Sinus Infection

It sure souunds like it. As I got older (about when i turned 59 now almost 62) they got so bad that I finnaly got a "CT Scan" which revieled that my sinus were fine and infection clear. You do want to make sure you dont have a infection that lingers and flairs up now and then. Sinus infection can be very dangerious. You sould get a scan also if you can.

I monitor a Weather Web site. I can't give you the URL (rules) but it goes by "weather Underground". There I find it easy to see what the bariometric pressure is doing and what it has done all day, yestersay and over the past year or so if I wish. There is a link on the page for "weather history" and you need to use that to see a graph of the BP.

IF you prove the change in BP also cause you problems you can tell your doctor that and he can help you seek proper relief.


Good Luck!
David

 
Old 02-12-2009, 02:01 PM   #10
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Re: Facial Migraines not Sinus Infection

David, thanks so much for the info! I'm heading to find the site now!

Thanks
Melissa

 
Old 02-12-2009, 06:15 PM   #11
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Re: Facial Migraines not Sinus Infection

Quote:
Originally Posted by shurluk View Post

I finaly got a "CT Scan" which revieled that my sinus were fine and infection clear. You do want to make sure you dont have a infection that lingers and flairs up now and then. Sinus infection can be very dangerious. You sould get a scan also if you can.
A scan will show the level of detail needed to see exactly what is going on. The sinuses are open cavities....Think of them as a cave. When the sinus is open and clear, the round cavity will show up in the scan as black. Conversely, if there is build up, or gunk in the bottom on the sinus, it shows up as gray. This "gunk" is like sludge...It's actually mucus...It's a permanent like build up that is settled at the bottom of the sinus....Think of it like the build up in bottom of a drain or pipe. When the scan is read by the radiologist and a report is sent your Doc, they will make a notation as to the level of mucus buildup in the sinus.

When one gets an infection that isn't successfully treated with antibiotics, the body will eventually fight off the infection by encapsulating the infection...It "wraps" around the infection and thus, creates a polyp. Not all polyps are the result of encapsulating infections, however. Some polyps are the result of allergies.

The more polyps, the more likely they interfere with the natural functionality of the sinus....Draining and etc. They can really create some blockage issues, which can then form a near perfect environment for further infections...Moisture, lack of drainage, and congestion. Excess moisture in the sinuses is a near perfect environment for infections due to the bacteria that is collected and is able to grow. It's not unusual for those with chronic sinusitis to have repeated infections due to the never ending cycle just explained.

Those with chronic sinusitis can get a lot of facial pain and headaches. When polyps are removed, they create scar tissue which can then create further problems. When polyps (upside down mushrooms) are removed, they are cut with an endoscope and the area has to scar over and heal on it's own....It can't be sutured...They are sliced off at the base of polyp...Where it attaches to the sinuses cavity. This is why you see sinus surgery patients wearing a drip pad under their nose....The wounds can bleed for up to a week after surgery.

Chronic sinusitis also can result in lots of swelling and pressure. Not only does the pressure and swelling cause headaches in itself, but if really bad, it can put pressure on the nerves in the area. Sometimes polyps in the sinuses will also add to the pressure and can affect the nerves in the area.

The bottom line is that when one has these problems in the facial area, a lot of different things can happen. People are effected differently....Each case is very individualized. Swelling in the facial area isn't like swelling in other parts of the body...It can really create a lot of problems and pain.

It's also very plausible that the sinuses may not be the primary "cause" of the facial pain / migraines, but instead, a contributing factor. Facial / head pain can be difficult to completely diagnosis.

Lastly, it's important to note that many use the term "migraine" incorrectly....It is often used as a general term in a way to describe a very bad headache overall.

Hope this helps.

Regards,

Ex

 
Old 02-12-2009, 07:21 PM   #12
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Re: Facial Migraines not Sinus Infection

Quote:
Originally Posted by Executor View Post
A scan will show the level of detail needed to see exactly what is going on. The sinuses are open cavities....Think of them as a cave. When the sinus is open and clear, the round cavity will show up in the scan as black. Conversely, if there is build up, or gunk in the bottom on the sinus, it shows up as gray. This "gunk" is like sludge...It's actually mucus...It's a permanent like build up that is settled at the bottom of the sinus....Think of it like the build up in bottom of a drain or pipe. When the scan is read by the radiologist and a report is sent your Doc, they will make a notation as to the level of mucus buildup in the sinus.

When one gets an infection that isn't successfully treated with antibiotics, the body will eventually fight off the infection by encapsulating the infection...It "wraps" around the infection and thus, creates a polyp. Not all polyps are the result of encapsulating infections, however. Some polyps are the result of allergies.

The more polyps, the more likely they interfere with the natural functionality of the sinus....Draining and etc. They can really create some blockage issues, which can then form a near perfect environment for further infections...Moisture, lack of drainage, and congestion. Excess moisture in the sinuses is a near perfect environment for infections due to the bacteria that is collected and is able to grow. It's not unusual for those with chronic sinusitis to have repeated infections due to the never ending cycle just explained.

Those with chronic sinusitis can get a lot of facial pain and headaches. When polyps are removed, they create scar tissue which can then create further problems. When polyps (upside down mushrooms) are removed, they are cut with an endoscope and the area has to scar over and heal on it's own....It can't be sutured...They are sliced off at the base of polyp...Where it attaches to the sinuses cavity. This is why you see sinus surgery patients wearing a drip pad under their nose....The wounds can bleed for up to a week after surgery.

Chronic sinusitis also can result in lots of swelling and pressure. Not only does the pressure and swelling cause headaches in itself, but if really bad, it can put pressure on the nerves in the area. Sometimes polyps in the sinuses will also add to the pressure and can affect the nerves in the area.

The bottom line is that when one has these problems in the facial area, a lot of different things can happen. People are effected differently....Each case is very individualized. Swelling in the facial area isn't like swelling in other parts of the body...It can really create a lot of problems and pain.

It's also very plausible that the sinuses may not be the primary "cause" of the facial pain / migraines, but instead, a contributing factor. Facial / head pain can be difficult to completely diagnosis.

Lastly, it's important to note that many use the term "migraine" incorrectly....It is often used as a general term in a way to describe a very bad headache overall.

Hope this helps.

Regards,

Ex
Hi,
This sound a lot like me. I have had the worst headache that you could ever think of. I had a root canal in Dec. and I did not let the denist finish because I had a bad experience with him. So I thought that it was my tooth acting up. I decided to go to the doctor and I told him what was going on. He took x-rays of my head and showed me the results. He was it was the worst case of sinus that he has ever seen in his 15 years of being a doctor. Where it was suppose to be clear, it was white as snow. I am having major headaches. My whole face hurts so bad, I am just in tears. This has been going on for about 3 weeks. He gave me a steroid shot in my hip, for nasal spary, and some kind of antibotic to take. I see a little change, but not enough. This mess is effecting my whole mood.

 
Old 02-12-2009, 08:22 PM   #13
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Re: Facial Migraines not Sinus Infection

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Originally Posted by Nese40 View Post
He was it was the worst case of sinus that he has ever seen in his 15 years of being a doctor.
Welcome to the boards and I'm sorry to hear about your situation. What type of Doc did you see? I would strongly suggest an ENT, if you haven't seen one already. You may need sinus surgery.

Take care,

Ex

 
Old 04-29-2009, 01:12 PM   #14
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Re: Facial Migraines not Sinus Infection

shurluk,

I have exactly your same symptoms - for almost 15 years now. Have been to the allergist (no allergies), the ENT (CT of sinuses was normal) and now have been referred to the Neurologist. But, I believe what you are saying is true, there is no rhyme or reason for these headaches, and no other pattern that I can see but the weather also. What I have found that offers me relief is a combo of Advil and Sudafed (the original, not the PE). When I have an especially long bout of it, I will get some antibiotics from my GP for a "sinus" infection. This seems to knock it out for a few days anyway. But yes, the allergist did tell me that my nose was especially sensitive and now I know that I am not crazy. Thanks for your post.

 
Old 05-01-2009, 08:31 AM   #15
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Re: Facial Migraines not Sinus Infection

Hello All,

Just thought I'd post a follow up from my neuro appt. yesterday. He told me I was getting a form of migraines that were caused by exactly what shurluck mentioned in his original post:

"My belief is that the cause of “Facial Migraines” has nothing to do with arteries. They are purely caused by the extremely sensitive sensors located in the frontal lobe of such sufferers. When they are stimulated by a smell, bright light or change in the “BP” this is what might be happening. The pain stimulates the Sinuses which cause them to produce coppice amount of sinus fluid with the intent of cleaning out the offending agent they perceive is the cause. This also is the cause of the “Pressure” most migraine (Esp. Facial) suffers will feel in there head."

He has prescribed Topamax for me to "dull" the oversensensitive nerve endings in the front of my head. Or I can go the wholistic approach first with Migravent. Not sure which I'll do at this point, just happy to have a diagnoisis that makes sense.

 
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