FOR IMMEDIATE RELEASE

New Study Shows Migraine Often Mistaken For Sinus Headaches

Findings Presented at the 44th Annual Scientific Meeting of the American Headache Society

TORONTO, Ontario (June 24, 2002) - For most people, the changing of seasons means warmer weather and spring flowers; however, for others, changing seasons means the onset of severe sinus pressure and nasal congestion that is frequently associated with so-called sinus headaches. Yet according to new research presented at the 44th Annual Scientific Meeting of the American Headache Society, these sinus-related symptoms may actually be caused by migraine, an underdiagnosed and debilitating neurobiologicial condition.

The study, conducted by the Headache Care Center in Springfield, Missouri, reveals 90 per cent of patients who have self-diagnosed sinus headache, and even many of those with a physician diagnosis of sinus headache, actually met established criteria for the diagnosis of migraine.¹

"We are seeing a growing body of evidence that suggests symptoms typically associated with sinus or allergy conditions can actually be migraine," said Dr. Curt Schreiber, M.D., a neurologist at the Headache Care Center and co-author of the study. "Because of the location of the pressure and pain, many patients, as well as healthcare providers, assume the sinuses or nasal passages are to blame. The wide variability of migraine symptoms probably explains why 90 per cent of patients in our study that were previously diagnosed with 'sinus' headache actually had symptoms fulfilling a migraine diagnosis."

One possible explanation for the confusion between migraine and sinus headache relates to the mechanism of migraine. The same nerves that carry migraine pain also go to the sinus area. Pain in the sinuses, face or around the eyes can be felt during a migraine on one or both sides of the head. Also, the nerves that cause stuffy or runny nose and watery eyes can be activated during a migraine.

"I thought my painful sinus pressure and congestion were sinus headaches for years, even though over-the-counter medications were not relieving my symptoms," said Crystal Kuntaroglu, a migraine sufferer. "When I finally kept track of my symptoms and talked to my doctor, we determined I was actually suffering from migraine. Now, with the right medicine, I can get on with my life."

Like Crystal, 66 per cent of study participants expressed dissatisfaction with their current headache treatment, which included non-narcotic analgesics (74 per cent), nonsteroidal anti-inflammatory drugs (NSAIDs) (72 per cent), decongestants (57 per cent) and antihistamines (48 per cent).

Migraine affects approximately 3.5 million Canadians and 28 million Americans, yet only an estimated 48 per cent of patients who meet the clinical definition of migraine have been diagnosed with migraine by a healthcare provider. Without proper diagnosis and treatment, migraine can often be a highly debilitating disease that takes a heavy toll on patients' work/school productivity and affects household work and family/leisure activities.

"This data could be very helpful for patients who thought they were suffering from sinus headache," said Dr. Gary Shapero, medical director of the Markham Headache and Pain Treatment Centre, Ontario, Canada. "The results should encourage people to discuss all their symptoms with their physician to get a proper diagnosis, and a treatment plan that will be most effective for them."

About the study

The study was conducted in more than 450 sites around the country evaluating 2,524 people ages 18-65 who had not had a previous migraine diagnosis, but who went to their primary care physician with self-described or physician-diagnosed sinus headache. Patients were asked to describe the symptoms associated with their typical sinus headache, and physicians used International Headache Society (IHS) criteria to diagnose the headache as migraine with or without aura, migrainous, tension-type or other headache type. Patients also completed the Headache Impact Test (HIT-6), an effective assessment tool used to standardize and measure the impact headaches have on a sufferer's daily life. Data was captured via a central touch-tone telephone entry system.

Additional Information

Migraine is a neurobiological disorder that affects approximately 3.5 million Canadians and can result in missed days of work, lost time with family and friends and a disrupted daily routine. According to a recent Statistics Canada report based on data from the 1998/99 National Population Health Survey (NPHS), it is estimated that migraine attacks account for seven million lost working days annually in Canada. Often, migraine can be characterized by symptoms including moderate to severe headache pain, nausea, vomiting, and sensitivity to light and sound, but migraine can also have other symptoms that are commonly interpreted as signs of sinus or tension headache (i.e., nasal congestion, runny nose, watery eyes, bilateral head pain and neck pain).

Because migraine can have many different symptoms, and appear like other types of headaches, it can be difficult for patients to recognize and for physicians to diagnose.

This study was sponsored by GlaxoSmithKline Inc., leaders in the treatment of migraine. GlaxoSmithKline Inc. - one of the world's leading research-based pharmaceutical and healthcare companies - is committed to improving the quality of human life by enabling people to do more, feel better and live longer. In Canada, GlaxoSmithKline employs approximately 1,800 people and is a top 20 investor in Canadian research and development, contributing more than $100 million annually. The company is also one of the top 10 corporate charitable donors, investing more than $6.5 million annually and is recognized as one of the 50 best companies to work for in Canada.

For further information about this news release, please contact:

Sherry Zarins/Laura Pagnotta

Edelman Public Relations Canada

Tel: (416) 979-1120

Carlo Mastrangelo/Catherine Jackson

GlaxoSmithKline Inc.

Tel: (905) 819-3000

Note to Editors:

Canadian Migraine Facts

• More than 15 per cent of Canadians between 18 and 65 years old suffer from some form of migraine
• Migraine headaches affect three times as many women as men
• Some common migraine triggers include:
• Alcohol (especially red wine)
• Dairy products (especially cheddar cheese)
• Fatty or fried foods
• Food additives
• Shifts in weather (e.g., a sudden change in climate)
• Hormonal factors (e.g., puberty, menstruation, pregnancy, menopause)
• Oral Contraceptive use
• Stress (extreme emotions - positive or negative)
  While all sufferers experience a variety of triggers that may indicate an attack, not all sufferers experience the same triggers.

¹International Headache Society diagnostic criteria for migraine without aura include:

1. At least five headache attacks lasting 4-72 hours (untreated or unsuccessfully treated), which has at least two of the four following characteristics: (1) Unilateral location; (2) Pulsating quality; (3) Moderate or severe intensity (inhibits or prohibits daily activities); (4) Aggravated by walking stairs or similar routine physical activity.
2. During headache at least one of the two following symptoms occur: (1) Phonophobia and photophobia; (2) nausea and/or vomiting.

Migraine disorder not fulfilling above criteria: Headache attacks which are believed to be a form of migraine but which do not quite meet the operational diagnostic criteria for any of the forms of migraine. Diagnostic criteria include: (a) Fulfills all criteria but one or more forms of migraine (specify type[s]); and, (b) Does not fulfill criteria for tension type headache.