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    What causes cluster headache, burning sensation in right nostril and eye?

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Posted on Sat, 26 Mar 2016 in Ear, Nose and Throat Problems
Question: Hello ... I'm 64 and suffer extremely, usually in the winter from abnormally dry nasal sinuses. My right nostril starts to burn, then under my right eye until my teeth ache. In essence the whole right side of my face burns so intensely that I develop a cluster headache. Throbbing also under the right ear. Sleep is whenever I can and work or concentration is almost impossible. I wake up with pain usually and my right eye is always bloodshot in the mornings. When it decides to go away, after a few weeks of torcher it simply disappears until it decides to come back.

I live in XXXXXXX state. The weather is moist so dry nostrils aren't due to cold dry weather. I wonder if I have a mold infestation of some sort in my body. Everything turns swampy and rots here in the winter but I actually came down with the headaches for the first time while snow-birding in Mexico... but I could have carried it with me from here. I've never been checked for a brain tumor or anything like that and I know others who have similar conditions. The mere fact is that I probably would have been dead by now if it was a brain tumor. I was fine all last year and thought I had conquered it when it did not happen last winter. But this winter it is here with a vengeance.
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Answered by Dr. Dariush Saghafi 3 hours later
Brief Answer:
Brain tumor highly unlikely for exactly the reasons you stated.

Detailed Answer:
Good afternoon.

As a headache specialist I can tell you that I see variations on this them all the time...including how other colleagues try and diagnose them as something other than what they turn out to be which are Trigeminal Autonomic Cephalgias...cluster headache being one of the most well known...and very possibly what you might have.

The best way to a diagnose in your case and to certainly rule out something within the skull that could be important (even if not a cancerous tumor) you should start a process of documentation of what I refer to as a HEADACHE DIARY or HEADACHE LOG and set up an appointment with a neurologist (preferably one who is a headache specialist). One of the first parameters I check on these patients is that of duration of the symptoms. Cluster headaches occur on a time line of 15-180 minutes and can frequently occur as many as 2-8x/day. Secondly, the majority of cluster headaches happen late at night and usually prior to 2-3 AM. They can wake people out of a dead sleep and most patients are inclined to walk about and pace throughout the episode as opposed to other headache types where people tend to try and stay extremely still.

I obtain imaging studies on my patients if the history and physical examination warrant the study otherwise, by obtaining the clinical characteristics and even just treating the episodes empirically with High Flow O2 using a non-rebreather mask for 15 min. or less the diagnosis can be made.

A fungal infection would not cause such a hemifacial presentation since it would be expected to progress after awhile...and if still not treated....probably result in the same bad outcome as if you were to have an untreated brain tumor for 6 years.....so I don't see that much as a possibility.

I think your doctor who passed away was on the right track..too bad the poor chap died before he could write you the script for the "good stuff" to try but I concur that O2 is the right approach. However, as I said above...be careful of my directions...they are precise. You need HIGH FLOW O2 which means at least 7-10L/min. (and this can be raised to 12-15L/min if necessary) put through a NON-REBREATHER mask which fits tightly to the face....it's not a lame nasal canula that does nothing but dry your nose out. O2 tanks that pump that type of O2 out have to have special valvular setups so that you don't get a XXXXXXX Candle taking off in your house when you flip the switch! LOL.....But I do think that is the ticket to ride if you want to try anything....and then, for prophylaxis, yes there are options.

I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload more specific information regarding lab tests and diagnostic studies if done and I'll be happy to look at them in the context of your question.

Otherwise, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.

Write to me any time at: bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.

Cheers!

This consult request has taken a total of 25 minutes of time to read, research, and respond.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2474 Questions

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