Contact Point Headache: What is it?

By Dr. Sumit Mrig in ENT(Ear Nose Throat)

Nov 08 , 2020 | 2 min read


Contact point headache (anterior ethmoidal neuralgia) is a rare type of cerebral pain that causes extraordinary anguish and distress in many patients. It is an uncommon type of  headache (sub-migraine) that displays itself as a persistent wounding or shooting pain in the single territory on face. It is possible that the patient will not be able to determine and treat this migraine. Several individuals see ENT surgeons, neurologists, dental practitioners, and specialists, despite that nobody is able to identify the cause of pain.

Also Check: Cervicogenic Headache

What Causes it?

There is an anatomic spot inside the nose, which compresses the nerve between two structures. It closely resembles leg sciatica of the nose/face. The nerve that gets squeezed is either the front ethmoid nerve or the nerves in the sphenopalatine ganglion. Common reasons are:

  • Cold wave
  • Hypoglycaemia
  • Emotional burst
  • Lot of tea & coffee
  • Lack of sleep
  • Poor dietary habit

Most Common Symptoms

  • Severe pain on one side of the face
  • The pain usually begins if the person has had upper respiratory infection
  • Sudden excruciating pain of the trigeminal nerve on the face, area of the eye , retro orbital, behind the ear, neck and shouldertrigeminal nerve on the face, area of the eye , retro orbital, behind the ear, neck and shoulder
  • Pain can be due to noise and sensitivity to light
  • Photophobia, water from the eyes, irritability, anxiety, depression
  • Loss of interest at work & fatiguability.

Is there any Treatment available?

There is no pill or nasal shower that can cure contact point migraines. Nasal splashes and decongestants can help incidentally as these solutions reduce the mucosal swelling, thereby calming any pressure on the nerve. If in case, the mucosal swelling repeats, tormenting pain can return.  

The standard headache treatment to treat this issue is “Surgery” in order to address the basic anatomic structures prompting nerve pressure. Surgery will require fixing the septum or uprooting the septal goad.

What is the Diagnosis?

  • ENT assessment, for example, nasal endoscopy to affirm the vicinity of a basic issue.
  • CT scan of the sinuses - is an imperative test to see that there is no fundamental anatomic hard abnormalities or sinus pathology.
  • CT sweep of the neck should likewise be possible if there is neuropathy of the sphenopalatine ganglion nerve alongside endoscopic proposal of a conceivable tumour at the base of the skull.
  • X-ray output can be requested by a neurologist to avoid any hidden mind/spinal pathology.
  • Contingent upon the finding of the CT check and nasal endoscopy, there is an indicative test which should be possible where nasal endoscope "touches" the contact guide zone all together to check whether it worsens or recreates the contact point migraine. At that point, there is a subsequent test done where a decongesting drug is connected to the area of the contact point to check whether it mitigates the torment.