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        New Message Board Archives >> 2005 Cluster Headache Specific Posts >> Why do sinus infections trigger cycles
        
(Message started by: pubgirl on Mar 19^th, 2005, 10:50pm)

Title: Why do sinus infections trigger cycles
Post by pubgirl on Mar 19^th, 2005, 10:50pm

Marsha and I have been discussing this on another thread.

Repeatedly I hear from sufferers that an unexpected cycle has been preceded by a nasty sinus infection. My current AND last cycles were exactly this.

Is it a coincidence due to the time of year?
Does a sinus infection somehow make the trigeminal nerve set something off in the brain?

What think you all?

W the B

Title: Re: Why do sinus infections trigger cycles
Post by E-Double on Mar 19^th, 2005, 10:56pm

I wonder about this too........

In fact I like many of us was always mis-diagnosed with
sinusitis or sinus infections until this cycle..last April wow nearly a yr.....finally got diagnosed in June......

point being.....so my cycle has not broken and I guess this means on the verge of chronic but things have "died" down throughout cycle to mostly 2-3 daily from 7........until........

BAM I got a wicked flu or bug of some sort and literally for that week I was back to "peak"

As that died down and went away many of the hits dissapated too.

I tend to think that it is more than coincidence.

If you are having some activity then that kind of irritation can easily set "it" off.

Hang in there ......glad the O2 prob. got resolved :)

Eric

Title: Re: Why do sinus infections trigger cycles
Post by pubgirl on Mar 19^th, 2005, 11:04pm

:-*Eric

02 even better now as an ingenious Uk sufferer who recognised that all the available masks, bags etc were not designed for the way we Ch sufferers use 02 has "invented" a great little bit of kit comprised of pieces of anaesthetic, Entonox and 02 therapy parts. It is simple and brilliant and is not only aborting my attacks faster but is also using way less 02 to do it.
Can't describe it here until I know what he plans to do with it, but as soon as I can I will.

W

Title: Re: Why do sinus infections trigger cycles
Post by floridian on Mar 20^th, 2005, 1:30am

Are you familiar with the neuroimmune hypothesis?? Infections activate the immune system, which affects neurotransmitters.

Quote:

Headache. 1996 May;36(5):312-5.

Putative neuroimmunological mechanisms in cluster headache. An integrated hypothesis.

Martelletti P, Giacovazzo M. Department of Clinical Medicine, Headache Centre, University La Sapienza, Rome, Italy.

During the last decade, numerous studies have been carried out to explore the function of the immune system in cluster headache and the release of reciprocal informational molecules from pain-sensitive structures. These neuroimmunological findings in cluster headache syndrome, although carefully considered, have varied from genetic aspects (HLA antigens) to functional activity of the immune system (NK cytotoxicity), and from study of the receptor expression of classical neurotransmitters of pain (5-HT, histamine) on immunocompetent cells, to the study of cytokines with a potent pro-inflammatory activity (interleukin-1). Other aspects considered have ranged from the study of the effectiveness of substances possessing a wellknown activity on the immune system (prednisone, lithium carbonate) in shortening cluster attacks to the 5-HT receptor expression changes observed on a peripheral substrate (monocytes) after the administration of sumatriptan. Although this was an exciting area of pioneering research, we have always interpreted our findings cautiously. In summary, we now believe that the neuroimmunological aspects of cluster headache can be proposed as an integrative model and that this immunological mechanism could improve our understanding of the pathogenic basis for this still obscure disease

Title: Re: Why do sinus infections trigger cycles
Post by pubgirl on Mar 20^th, 2005, 4:55am

Floridian

Then why don't all infections trigger a cycle for me, it seems to be only the sinus ones?

Title: Re: Why do sinus infections trigger cycles
Post by catlind on Mar 20^th, 2005, 9:07am

Perhaps it's something to do with the ongoing argument about one aspect of the cause - oxygen levels.

Some schools of thought are that low oxygen levels are the trigger and that's why O2 aborts. A sinus infection would presumably decrease the amount of oxygen you are processing because you can't breathe properly.

Not sure I buy into that school of thought, but it's a thought.

Cat

Title: Re: Why do sinus infections trigger cycles
Post by floridian on Mar 20^th, 2005, 9:26am

on 03/20/05 at 04:55:09, pubgirl wrote:

Floridian

Then why don't all infections trigger a cycle for me, it seems to be only the sinus ones?

Not sure, probably with a sinus the local inflammation affects the trigeminal.

http://www.med-owl.com/clusterheadaches/tiki-index.php?page=Sinus%20Problems

Title: Re: Why do sinus infections trigger cycles
Post by nani on Mar 20^th, 2005, 9:37am

The last time that happened to me, the ER doc suggested that it was a combination of low oxygen levels and inflammation. 15lpm in the ER didn't touch the hits (which were happening over and over again....15 min k10's with a 15 min break in between). I agree about the inflammation, because the CH were on the other side, which was the side that was inflamed and impacted. Once the infection cleared up, my CH returned to my normal CH side.

Title: Re: Why do sinus infections trigger cycles
Post by pubgirl on Mar 20^th, 2005, 9:39am

Should have looked there first before I posted Jonathan, sorry :-[

:-* :-*
Wendy

Title: Re: Why do sinus infections trigger cycles
Post by eyes_afire on Mar 20^th, 2005, 2:50pm

I've never had a sinus infection 'trigger a cycle' but I've noticed that my CH becomes significantly worse during a sinus infection. I think it's related to the immune system. I have no proof, it's just a hunch. There may be several contributing factors to the expression of CH. I can tell when I'm going to get a sinus infection a couple of days in advance of the symptoms... I become EXTREMELY sleepy, somewhat depressed, and my skin gets shitty. I attribute it to an immune response.

--- Steve

Title: Re: Why do sinus infections trigger cycles
Post by Ellick on Mar 20^th, 2005, 3:47pm

I think that clusterheadaches could well be caused by sinus infections of a very particular type. Fungal infections. Fungal spores are carried on dust particles and could lay dormant in the sinuses for years. Only a certain percentage of people with sinus infections display the symptoms. If many sinus infections are fungal it would explain why antibiotics have so little effect. Ons study I read recently reported that out of 220 people who had sinusitis 212 had fungal infection as the cause. My guess is the symptoms of sinusitis could depend on immune response. Maybe a microspic myceleum could penetrate through to the blood vessels and even down to the carotoid artery thereby triggering the hypothalmic response that we all live with.
Further, it could explain why episodes are seasonal and chronic could be like a change which results in continual fruiting of the fungus. It could also explain why some alkaloids have a strong effect.
I am currently trying to track down a fungus expert(anyone know of one) who can tell me if alkaloids in different fungii kill of or alter others. The fungal infections could be several different types so one treatment will work for one and not others. These infections could establish themselves in us at an early age.

Waiting here to be shot down!

ET

Title: Re: Why do sinus infections trigger cycles
Post by floridian on Mar 20^th, 2005, 6:30pm

Not sure about the fungal role - the numbers that you quoted for people with sinusitis with fungi is interesting, I don't know much about fungal sinus infections, will check.

>> it could explain why episodes are seasonal and
>> chronic could be like a change which results in continual
>> fruiting of the fungus.

The seasonality is due to more than a change in the air quality. My clusters are closely linked to both the calendar and the clock, and there is evidence that it goes to the circadian pacemaker in the brain (Suprachiasmatic Nucleus in the hypothalamus). But sinuses are clearly involved for many people, and some of those could be plagued by fungi (bad fungi, that is, as opposed to the many good ones).

Title: Re: Why do sinus infections trigger cycles
Post by Lizzie2 on Mar 20^th, 2005, 6:40pm

All good points...

I know I've been one to mention a sinus connection with my CH...and not just that sinus congestion is a symptom of CH, but that sinus congestion is a trigger.

I'm not sure about the O2 deficit hypothesis, although I suppose that could be true. The only reason I would question it is that many times I'll be in the ER or the hospital, and I tell them that I need to use O2 for clusters...and how to do it. They put a pulsox sensor on my finger and tell me I don't need oxygen because my pulsox is 100%. I've never had a pulsox drop below 90 that I know of, which indicates that my oxygenation is fine.

This may not be the case for all cluster sufferers...especially if anyone has any sort of lasting effects from smoking that lower the oxygen levels in their blood and increase levels of carbon dioxide (in an emphysema type way...)

However, from what I understand...the theory that makes sense to me is that high floow, highly concentrated oxygen works as a very powerful vasoconstrictor. It constricts any out of control dilating vessels in the brain/headache area. I thought that's why it helped. Because if it was a matter of simple O2 sats, then we'd find a lot more relief with other methods than just a mask. Because even a nasal cannula can be used up to about 6LPM (your mileage may vary depending on what your hospital standards are), and therefore it can significantly raise O2 sats. But yet, the nasal cannula is worthless for a CH'er.

Just a thought!

Carrie :)

Title: Re: Why do sinus infections trigger cycles
Post by BikerBob on Mar 20^th, 2005, 8:20pm

Here's an interesting tidbit...

At the beginning of my last cycle, I had no signs of sinus infection. My sinuses seemed clear and normal, but...

During the week immediately preceding the beginning of my last cycle, I got three chalazions on my eyelids. A chalazion is a sign of an infected eyelid gland, but unlike a sty, it is a firm, round, smooth, painless bump usually some distance from the edge of the lid. A chalazion is caused by the blockage of the tiny gland duct that helps lubricate the eyelid. Bacteria may grow within the blocked gland; the resulting inflammation causes the hard bump.

Bob

Title: Re: Why do sinus infections trigger cycles
Post by floridian on Mar 20^th, 2005, 8:38pm

I wonder how much good a nasal corticosteroid spray would do ... not sure that anyone investigated that option. It might bring down the sinus problems and cool the trigeminal nerve, with fewer side effects that oral steroids.

(related note - a new post will be going up soon on the use of a single high dose of steroids for treating clusters - not a magic bullet, but helps some, also with fewer side effects that a 10 day taper. Check the treatments section after 9:00 pm EST tonight)

Title: Re: Why do sinus infections trigger cycles
Post by Lizzie2 on Mar 20^th, 2005, 9:07pm

Like using FloNase?

I do know that at least in class we learned that using an inhaled or nasal spray medication causes far fewer systemic effects. If it helped to get a steroid nasal spray for CH, that would be a very cool concept. They might even actually allow me to take it if it didn't have any systemic effects that would progress the AVN.

Now I want to know more between your post here and the research you posted on the meds board.

L2

Title: Re: Why do sinus infections trigger cycles
Post by pubgirl on Mar 21^st, 2005, 2:03am

Trouble with that concept is that I found when I used Imigran nasal during this recent sinus infection, I could still taste the Imigran dribbling down the back of my throat many hours later and it wasn't aborting the attacks properly, leading me to believe that during a sinus infection the Imigran nasal spray didn't get absorbed by the membranes as it should do.
Ordinarily Imigran nasal aborts in less than 10 minutes for me.

Wendy

Title: Re: Why do sinus infections trigger cycles
Post by JJA on Mar 21^st, 2005, 9:49am

It could be that the cart is before the horse here. Maybe when an episode is starting, before there's any pain, the sinuses swell shut creating a breeding ground for infection. Also possible, but it seems less likely, there is not really an infection at all. Sinus infections are diagnosed by their immune responses; inflamation, discharge etc. (right?) If Ch causes these things, it would appear as a sinus infection. This could also explain other observations. If Ch got worse, the swelling could get worse. It looks like an infection made the headaches worse when really it's just different symptoms of the same problem--Cluster Headaches.

Jesse

Title: Re: Why do sinus infections trigger cycles
Post by Ellick on Mar 21^st, 2005, 12:28pm

'The seasonality is due to more than a change in the air quality. My clusters are closely linked to both the calendar and the clock, and there is evidence that it goes to the circadian pacemaker in the brain (Suprachiasmatic Nucleus in the hypothalamus). But sinuses are clearly involved for many people, and some of those could be plagued by fungi (bad fungi, that is, as opposed to the many good ones). '

In relation to seasonal effect my understanding is that fungus is also on a timer. I don't know what triggers the timer or if it is set from the outset or why it sometimes varies. My episodes have never really followed much of a pattern with one exception. That is I do not llike using steroid nasal spray except every now and again. I think my last 3 episodes started 6 weeks after using it
I wonder if there is one or more likely several triggers (perhaps dependent on metabolism and either or immune response) which kick it off some of which might be circadian or other external factors i.e. sunlight, humidity, smells, restriction of blood vessels and so on. I am saying this in relation to my idea that fungal infection could be responsible and it is the fungus that accelerates, deccelerates, fruits increases in alkaloid content or whatever.

ET.

Title: Re: Why do sinus infections trigger cycles
Post by sundancer on Mar 21^st, 2005, 1:23pm

This is really interesting to me. Had CH for 30 yrs. , 3yrs ago, a CT scan revealed a sinus cyst (on the CH side), ENT doc wants me to have surgery to remove it and some diseased sinus area, also have a deviated septum. Have yet to decide to have the surgery, heard too many sinus surgery horror stories. Use nasonex, most of the time, but quit a few months ago and now am in the middle of CH, which is unusual as normally it comes in the summer.

If that didn't all make sense it's due lack of sleep and the large amount of sh_ _ I'm taking trying to keep PF.
Maybe I should just go have the surgery, and take my chances.

Anybody had sinus surgery?

Title: Re: Why do sinus infections trigger cycles
Post by Lizzie2 on Mar 21^st, 2005, 3:58pm

Sundancer,

I had sinus surgery on March 8 (read post above or somewhere around here!) I was admitted overnight due to post-op complications (nothing to do with the surgery itself, which went fine) and then admitted to the ER last Friday at about 3am with post-op hemorrhage, and now I've been bleeding for the past 4 days...on and off.

I'm really really hoping it was worth it, and I wouldn't discourage the surgery for anyone...but I will say in advance that I have yet to hear anyone say a thing except, "Recovery from sinus surgery really sucks!"

So....I hope it is worth it, and I still wouldn't have chosen NOT to do it, but...just know that if you do choose to have the surgery, it is no picnic and the recovery can be rather lengthy, messy, and painful!

However...if the end result is there, then it'll all be water under the bridge. :)

Carrie :)

Title: Re: Why do sinus infections trigger cycles
Post by Lizzie2 on Mar 21^st, 2005, 4:01pm

on 03/21/05 at 02:03:47, pubgirl wrote:

Wendy,

I'd definitely agree about the nasal sprays we use...Zomig doesn't have near the effect when I am having an infection or blockage... At least that's the case for me.

However the unique part about what Floridian is saying is that he's talking about steroid nasal sprays. These sprays work on the sinuses and are designed to unblock them. So...they may actually work better for those of us who have sinus problems which trigger CH (forget about the sinus symptoms of CH...that's another story) because they would work on both the sinuses and the headache.

Maybe?

My former neuro answered my email question saying that he has never heard of steroid nasal spray being used for CH. I told him if ENT puts me on it in the future, I will be my own little test pilot to see if it also helps my CH. :)

Lizzie2/Carrie :)

Title: Re: Why do sinus infections trigger cycles
Post by Ellick on Mar 21^st, 2005, 4:09pm

Sundancer. I had sinus surgery about 5 years ago. It was successful in that my breathing is much better. My septum was also 'bored' out a bit and I had polyps removed. It was day surgery and I felt rough after the surgery BUT I had alcohol the night before so it was my own fault. The surgery was worth it to me.

I guess the best way is to get as much advice as you can and do what suits you at the end ofthe day.

Whatever you decide, all the best.
ET.

Title: Re: Why do sinus infections trigger cycles
Post by maffumatt on Mar 21^st, 2005, 6:04pm

I dont get sinus infections before a cycle, I get them after. I believe that the interrupted sleep cycles, eating, and stress reduces your bodys ability to fight infections.

Title: Re: Why do sinus infections trigger cycles
Post by Ellick on Mar 21^st, 2005, 6:49pm

on 03/21/05 at 18:04:07, maffumatt wrote:

I dont get sinus infections before a cycle, I get them after. I believe that the interrupted sleep cycles, eating, and stress reduces your bodys ability to fight infections.

Why not other infections if the immune system is lessened?

ET.

Title: Re: Why do sinus infections trigger cycles
Post by pubgirl on Mar 21^st, 2005, 7:11pm

Lizzie

I was using Nasonex for the sinus infection as well as Imigran and 02 for the CH, and was getting slaughtered with attacks, can't see it helped the Ch at all

W

Title: Re: Why do sinus infections trigger cycles
Post by maffumatt on Mar 21^st, 2005, 7:31pm

Why not other infections if the immune system is lessened?

ET.

my point exactly, I also get a cold sore after a month of being in cycle. I only get them if im sick.

Title: Re: Why do sinus infections trigger cycles
Post by TonyG1 on Mar 21^st, 2005, 8:20pm

on 03/21/05 at 18:49:56, Ellick wrote:

Why not other infections if the immune system is lessened?

ET.

Good question. It is rare for me to get "sick", I sometimes think my immune system is in overdrive most of the time -- I couldn't tell you the last time I had so much as a cold ... my Neuro gave me medrol a week or so ago and it evoked a rather ugly response / reaction. Apparently, my immune system did the opposite from the expect result ... [smiley=huh.gif]

Title: Re: Why do sinus infections trigger cycles
Post by godsjoy777 on Mar 21^st, 2005, 9:56pm

I had been pain free for 2 full weeks but had a sinus infection....cold etc.....but pain free mind you....FINISHED my cycle or so I thought....after 3 months....my "normal" cycle....except for a 5 month one last year.......ANYWAY.....After the sinus....cold infection, I got hit bigger than ever.....worse than ever....several hits day and 3 hits every night.....I think we might be onto something.....I've also been diagnosed with acute sinusitis....though I don't always "feel" sinus problems...
hmmmmm....very interesting. :-/
Karen

Title: Re: Why do sinus infections trigger cycles
Post by ben_uk on Mar 22^nd, 2005, 4:00pm

"Ingenious"
Thank you Wendy, I'm flattered.
:oBen

Title: Re: Why do sinus infections trigger cycles
Post by Renee on Mar 28^th, 2005, 5:20am

Sundancer,

Make SURE you have an otolaryngologist that is well versed in sinus surgeries if you choose to have the surgery.

In 1999 I went in for day surgery on my sinuses for some headaches of unknown cause..ch.

The surgeon allowed the instrument to go too far up into my sinus cavity and the instrument went right thru the ethmoid bone, tore the dura around my brain and perforated my brain. I woke to spinal fluid pouring out my nose continually. Since circular holes will not heal in bones of adults, I had to be transferred to another hospital for a repairative surgery where the specialist took skin, muscle and fascia from behind my left ear and glued to the bottom of my ethmoid bone in hopes of stopping the CSF leakage. I continued to leak after this patch surgery so a lumbar drain was placed in my lower back and 15cc of spinal fluid was drained from my spinal column every 4 hours in hopes of relieving some of the pressure off the the new patch and giving it time to adhere to the ethmoid bone. This finally did the trick but I was being treated for menengitis the entire time as a precaution as well. 17 days after the initial day surgery I was released from ICU. Today I live with only the skin patch separating my cranium from my sinuses in an 8x9 mm area and it the patch ever leaks I will have to have a craniotomy and a metal plate inserted under my brain and on top of the ethmoid bone to stop the leakage. :o

This botched surgery left my life with many limitations as I now have to protect the patch from any jolts or being jarred. I can no longer snorkle, scuba dive, ride or break horses, snow or water ski, lift more than 30 pounds, etc etc. :'(

PLEASE think hard and long before opting for a sinus surgery and make sure you are using the best surgeon around.

That headache that was the cause of the sinus surgery...was clusters. The surgery did nothing for the clusters but only added additional type of headaches. >:(

Let no day surgery be taken lightly! 8)
Renee

Title: Re: Why do sinus infections trigger cycles
Post by sundancer on Mar 28^th, 2005, 4:38pm

Thanks Renee, for the reply.

If I had the sinus surgery, it would be because I secretly wish for it to relieve the CH. Realistically I can live with the sinus trouble, and at this point would rather do that, than have surgery.

Still PF and taking the "zu"....... it's so nice to sleep!