Migraine diagnosis in patients with sinus headache symptoms: a cross-sectional study at Khartoum ENT Hospital

Background Sinus headache is the most common diagnosis reported by patients with migraine who received a non-migraine diagnosis. Thus, the aim of this study was to determine the prevalence of migraine among patients present with sinus headache to Khartoum ENT Hospital. Objective To study the prevalence of migraine (using IHS criteria) among patients present with sinus headache at Khartoum ENT Hospital. Methods This is a cross-sectional hospital-based study conducted at Khartoum ENT Hospital in the period between July 2022 to February 2023 including all patients with self-reported or physician diagnosed "sinus headache", without a suspected secondary cause of headache. Diagnosis of migraine was made using the IHS criteria. Data was collected by the researcher, entered and analyzed using SPSS. Results This study included 197 patients with a mean age of 33 +/- 10 years, and female predominance 129 (65. 5%). The most common presentation was nasal blockage 178 (90.4%), flowed by facial pain 87 (44.7%), and nasal discharge 42 (21.3%). Autonomic symptoms included lacrimation 71 (36%), conjunctival injection 20 (10%), and eyelid edema 6 (3%), and 26 (13%) had positive family history of migraine. The prevalence of migraine was 67 (34%); 40 (20%) without aura and 27 (14%) with aura. Migraine was significantly associated with autonomic symptoms, and family history of migraine, and poor response to NSAIDs and nasal sprays compared to non-migraine headache (P-value < 0.05). Conclusion Migraine is not uncommon as 34% of patients with self-reported or physician diagnosed sinus headache meet the International Headache Society (IHS) criteria of Migraine. Migraine was associated with autonomic symptoms and a positive family history of migraine. The presence of good response among those who used antimigraine medications may aid the diagnosis of migraine.