Facial migraine in a rhinological setting

This study aims to investigate the incidence of migraine involving the face in a rhinology clinic and to describe its characteristics. It is a study of a cohort of 973 patients consecutively presenting to the outpatient clinic with symptoms of facial pain and/or rhinosinusitis. The study subgroup consisted of patients with facial pain and migraine excluding cluster headache and paroxysmal hemicrania. We studied the features of 51 patients who had facial pain with migraine. The diagnosis was based on the criteria used by the International Headache Society and was also supported by the outcome and response to treatment after a mean of 2 years and 2 months. Of the 973 consecutive patients, 409 (42%) had symptoms of facial pain and/or head pain or pressure. Fifty-one (12%) had migraine. Of these, 39 (76%) had unilateral pain and, in 12 (24%), it was bilateral. The distribution affected the forehead and/or eye or cheek in 32 (63%) patients. Twenty-four (47%) had migraine isolated to the second division of the trigeminal nerve. Twelve per cent of patients attending a rhinology clinic with facial pain had migraine. Of particular interest were the 6% of patients with facial pain who had migraine confined to the second division of the trigeminal nerve. This entity is not widely recognized and has rarely been described in the literature.