title: The response to sodium valproate of patients with sinus headaches with normal endoscopic and CT findings.
abstract: The objectives of this study are to evaluate the patients who have sinus headaches, either self-ascribed or physician-diagnosed, and to determinate the response to sodium valproate in a prophylactic treatment of the patients without positive sino-nasal findings. "Sinus headache" is a patient's complaint or physician-diagnosis that can have a variety of underlying causes. The patients are often treated with multiple courses of antibiotics and occasionally undergo a sinus surgery, often with little or no relief of their symptoms. One hundred and four patients with "sinus headaches" were evaluated prospectively. The patients with a normal rigid nasal endoscopy and a paranasal sinus computed tomography scan were treated with sodium valproate as a prophylactic treatment. After a 3-month follow-up, the patients' response to the treatment was evaluated. Seventy-two patients (69.2%) did not have any positive sino-nasal findings in the nasal endoscopy and the computed tomography scanning. The response rate to the treatment for these patients was as follows: significant improvement in 44 patients (61.1%), partial response (9.7%), no response (15.3%), and ten patients (13.9%) withdrew or failed to follow-up. According to Wilcoxon test, the patients' response rate to sodium valproate was statistically significant (P = 0.001). In conclusion, a majority of "sinus headache" patients do not show any positive sino-nasal pathologic finding. Therefore, we have to consider migraine headache as a considerable cause and sodium valproate as an effective conservative treatment.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Shahid Sadoughi General Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. drdadgarnia@yahoo.com
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Dadgarnia
authors.forename: Saeed
authors.initials: S
authors.lastname: Atighechi
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Baradaranfar
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D004334:Drug Administration Schedule; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000188:drug therapy*; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010256:Paranasal Sinuses; D012220:Rhinitis / Q000150:complications / Q000175:diagnosis; D055502:Secondary Prevention; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D014635:Valproic Acid / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D003692:Delayed-Action Preparations; D014635:Valproic Acid