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Facial & eye pain. No aura as usual. Sinus infection missed on CT?

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Created: July 10, 2006

Facial & eye pain. No aura as usual. Sinus infection missed on CT?

Question: Facial & eye pain. No aura as usual. Sinus infection missed on CT?

Answer:

Full Question:

My head started hurting four nights ago. The throbbing was only on the left side (my left) of my head, with most of the pain behind my left eye. I often get headaches, and occasionally migraines, so I took an Excedrin, but continued to toss and turn all night. I have Imitrex, but this did not present as a migraine with the visual distortions I normally get, and it was only on one side, so I didn't take the Imitrex. Also, once my migraines start, the Imitrex is mostly ineffective. I expected to be fine in the morning, but the pain continued, and my face began to hurt, if touched--my left cheekbone, left forehead, left side of my nose, even my eyelashes on my left eye hurt to the touch at one point. This facial pain was sometimes worse in one place or the other--all only on the left side. Occasionally, a pain would whoosh through my left ear, to the eye. Sometimes the pain was worse than others., sometimes just a dull ache. This started on a Saturday night. By Monday I tried to make a doctor's appt, but could not get one until Wednesday. On Tuesday night, went to the emergency room, because I felt frightened and have never had a headache last this long with no other symptoms. My husband had convinced me I had a sinus infection, as he had suffered these exact symptoms before and that was what he had. They gave me a Compazine/Benadryl combo intravenously that sent me into a panic attack. I was very sorry I had gone to the emergency room, as I continued to be somewhat panicky even after they had given me valium to calm me down. They did a CAT scan which was normal--no sinus infection. Finally went home after five hours with Napronex and Valium prescriptions and my headache mostly gone at that point. I went to sleep but woke up a few hours later with my left eye again hurting. My left side headache continues, although not as severe. I have never had a headache like this, localized only on one side, that wouldn't go away. I have had no nausea, or dizziness, or weakness, except from the meds. I also have had no visual disturbances that I can tell, although I cannot read for very long without discomfort. I don't like taking medication, and was really hoping this was a sinus infection that could be cured easily with antibiotics. Could a sinus infection have not shown up on the CAT scan? I am not having any cold symptoms. At this time, the pain is all on the far left side of forehead, corner of left eye. Thanks for any help.
 

Answer:

Hello;

First, when you finish reading this, please call your doctor and make an appointment. It's always good to let your doctor know that you've had to go to the ER, and if the problem isn't resolved by the ER visit, you should always follow up with an appointment with your doctor.

It's important to know that only about 25% of Migraineurs experience visual disturbances and other aura symptoms. Of those, very few experience that aura phase with every Migraine. This article should be helpful to you:

    Anatomy of a Migraine
    When many people think “migraine” they think only of the pain of migraine. In reality, a migraine episode consists of far more. The typical migraine episode actually consists of four parts, referred to as phases or components.

It's impossible for us to say via the Internet if your symptoms are from Migraine, but it's a definite possibility to discuss with your doctor. When infection isn't present, it's actually rare to have a "sinus headache." It's not uncommon to have facial and eye pain from Migraine because of the location of the trigeminal nerve, which becomes inflamed during a Migraine attack. Take a look at:

  • Sinuses Giving You a Headache? It's Probably a Migraine.
    If you've tried various over-the-counter sinus medications to relieve your sinus headaches to no avail, there may be a good reason: chances are you don't have a sinus headache at all. Nearly 9 in 10 people with sinus headache symptoms likely are suffering from Migraines.
  • Pathways of Migraine:
    Illustration of the actions of a Migraine and location of the trigeminal nerve.

It would be unusual for a sinus infection to be missed on a CT scan, but again, this needs to be verified with your doctor.

Good luck,
Teri Robert and John Claude Krusz

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Important Note: Material on this page is for informational purposes only, and should not in any way be construed as medical advice. Always consult your own physician with questions about your headaches or Migraines.

More Headaches & Migraines Q&A
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  5. Ask the Clinician with Dr. John Claude Krusz and Teri Robert for About Headaches and Migraine: Question and Answer #2 for 07/10/06

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