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Experiencing unpleasant smell and severe headache. Could this be chronic sinusitis?

Jan 2013
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Answered by

Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
hi for the past four months now i have been experiencing an unpleasant smell up my nose with an increased amount of headaches. This is noticeable every day and i am starting to get concerned. Feel if i go to the G.P. and say i have a nasty smell up my nose he will think i am nut!!
Do you think this could be chronic sinusitis or something more sinister like a brain tumour.
thanks XXXXXXX

I am 61 years old with a past medical history of invasive breast cancer 12 years ago. Slightly raised cholesterol for which i am taking a statin. No other medication.
Posted Tue, 11 Jun 2013 in Ear, Nose and Throat Problems
Answered by Dr. Mayank Bhargava 1 hour later
Welcome to XXXXXXX forum.

Let me know the associated feature along with mentioned.
Do you have nasal blockage/ running nose/ frequent sneezing/ recurrent vomiting?
Do you have decreased smell sensation & blurred vision also?
Are you getting foul smelling nasal discharge?
What is the type of headache?
Do you have any aggravating or relieving factor for this headache?

There are at least 15-20 types of headache have been defined and diagnosis is made generally on the basis of history defined by patient.
Migraine is the most common type of headache and is a syndrome made up of multiple symptoms.
Migraine is associated with pulsatile type of headache, gets aggravated by lack of sleep, exposure to noise and sun light, excessive tea and coffee.
Tears from eyes and running nose is a feature of tension headache and at times, two sub types of headache may be present in a single patient.

With the available described symptoms, there also appears to be possibility of Paraosmia; altered smell sensation.
Paraosmia could be due to sinusitis or could be a associated manifestation of migraine.
As you have past history of invasive breast cancer; possibility of spread should also be kept in mind.

You should consult with XXXXXXX medicine specialist/ neurologist and should go for thorough neurological check up.
You should also go for complete blood count, erythrocyte sedimentation rate, CT/ MRI scan of head, XXXXXXX
You should consult with ENT Surgeon and should go for thorough check up.

Treatment depends on exact diagnosis.
Meanwhile, you should take sumantriptan along with naprosyn, divalproex and propranolol on written prescription from your local doctor.
If naprosyn alone is not able to control headache, then you can also take ergotamine and tolfenemic acid.
As such treatment of paraosmia is difficult and you can get relief with Methylcobalamin and pregabalin.

Hope that helps.
Let me know your other query.
Take care,
Dr. Mayank Bhargava
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