Major Causes of Headaches in the U.S.
Headaches are a widespread health concern in the U.S., with various factors contributing to their onset. Major causes of headaches include:
- Tension-type headaches - Often caused by stress, muscle tension, or poor posture, these headaches typically produce a dull, pressing pain around the forehead or back of the head.
- Migraines – Intense, throbbing headaches that can be accompanied by nausea, sensitivity to light or sound, and sometimes visual disturbances known as aura.
- Cluster headaches – Severe, one-sided headaches that occur in cyclical patterns or “clusters,” often around the eye, accompanied by tearing or nasal congestion.
- Rebound headaches from medication overuse – Headaches that develop when pain-relief medications are taken too frequently, causing a cycle of recurring pain.
- Secondary headaches related to underlying medical conditions – Headaches that are a symptom of another health issue, such as high blood pressure, infection, or neurological disorders.
- Sinus-related headaches - Characterized by pain and pressure in the forehead, cheeks, and around the eyes, often triggered by sinus infections or inflammation, and commonly mistaken for other types of headaches.
What Is a Sluder’s Syndrome (Sphenopalatine Ganglion)?
Sluder’s syndrome, also known as sphenopalatine ganglioneuralgia, is a rare condition that can cause severe unilateral facial pain, often misdiagnosed as a sinus headache. This condition involves inflammation of the sphenopalatine ganglion, a nerve cluster located in the nasal cavity, leading to intense facial pain.
Symptoms of Sluder's Neuralgia
Facial Pain
One of the hallmark symptoms of Sluder’s neuralgia is intense facial pain that typically affects one side of the face. The discomfort often originates near the posterior wall of the nasal cavity and can radiate to the cheek, eye, or forehead. Those who suffer from this condition frequently describe the pain as sharp, burning, or stabbing, making daily activities challenging.
Nasal Congestion
Many individuals with Sluder’s neuralgia experience nasal congestion, often limited to the side of the face affected by the nerve inflammation. This congestion can worsen during flare-ups, contributing to feelings of pressure and discomfort that are sometimes mistaken for a typical sinus headache.
Eye Symptoms (Tearing, Redness, and Swelling)
Eye-related symptoms are common in Sluder’s neuralgia and can include tearing, redness, and swelling of the eye. Patients may also report irritation in the affected eye, which can accompany the facial pain and intensify discomfort throughout the day.
Flushing on the Affected Side of the Face
Another distinguishing feature of Sluder’s neuralgia is flushing on the affected side of the face. This visible redness often occurs alongside other symptoms, such as facial pain and nasal congestion. It reflects the involvement of the sphenopalatine ganglion in regulating blood flow and nerve activity in the region.
Causes of Sluder's Headache
Deviated Septum
A deviated septum can contribute to Sluder’s headaches by obstructing airflow and altering normal nasal function. When the septum is misaligned, it can put pressure on nerves within the nose, potentially triggering pain and other related symptoms. People with a significantly deviated septum may notice that one side of their nose feels more congested or tender, especially during flare-ups.
Septal Spurs (Sharp Bony Projections)
Septal spurs are sharp bony projections along the nasal septum that can irritate the surrounding tissues and nerves. These spurs can act as a mechanical trigger for Sluder’s headaches, causing localized pain that often worsens with nasal pressure or movement.
Concha Bullosa (Air-Filled Cavities)
Concha bullosa refers to air-filled cavities that develop within the nasal turbinates. When these cavities enlarge, they can compress adjacent nerves and contribute to the onset of Sluder’s headache. The presence of concha bullosa can also exacerbate nasal congestion and facial pressure, intensifying symptoms.
Tumors or Cysts
Although rare, tumors or cysts in the nasal cavity or sinus region can lead to Sluder’s headache by compressing the sphenopalatine ganglion or surrounding structures. These growths may produce persistent pain and other symptoms similar to those caused by more common nasal issues, making diagnosis more challenging.
Nasal Trauma
Trauma to the nose, whether from an accident, sports injury, or surgery, can disrupt normal nasal anatomy and irritate nerves within the nasal cavity. This irritation can trigger Sluder’s headaches, particularly if the injury affects the posterior wall, septum, or surrounding structures involved in nerve signaling.
Receive Professional Treatment for Sphenopalatine Neuralgia (Sluder's Headaches) at Texas Sinus & Snoring
At Texas Sinus & Snoring, patients who suffer from severe headache pain caused by sphenopalatine ganglion (neuralgia) can receive comprehensive care tailored to their needs. Our specialists begin with a thorough review of each patient’s medical history and symptoms to identify the underlying mechanisms contributing to their condition. Advanced imaging techniques, including CT scans and MRIs, are commonly used to support diagnosis and ensure that all contributing anatomical factors are taken into account.
During evaluation, a nasal endoscope (a thin tube with a camera) allows our team to visualize the nasal cavity in detail, helping pinpoint areas responsible for sensory irritation and pain. Once the source of the headache is clearly identified, our specialists develop a treatment plan designed to relieve symptoms and reduce the duration and frequency of pain.
Treatment options range from non-invasive interventions to targeted procedures. Each surgery performed by our specialists aims to achieve excellent results and minimize discomfort. Follow-up care ensures that patients experience lasting relief, allowing our team to review progress and make adjustments as needed for optimal outcomes.
Conclusion
Sluder’s headache is an uncommon condition associated with the sphenopalatine ganglion, where parasympathetic fibers synapse and connect with structures such as the lacrimal gland, the soft palate, and areas of the mouth. The pterygopalatine ganglion, located in the pterygopalatine fossa near the foramen rotundum, plays a central role in transmitting sensory and motor signals, with the trigeminal nerve providing additional connection to the lateral and middle aspects of the face. Anatomical structures like the perpendicular plate and palatine bone are also involved in the presentation of pain and gustatory manifestations.
Patients typically present with facial pain and other neurological symptoms, and the presence of infection or other complications can exacerbate the condition. Neurologists and sinus specialists work together in the management of these cases to accurately identify the source of discomfort and treat the underlying causes. After completing evaluation using imaging and endoscopic techniques, patients can often achieve significant improvements in both pain relief and functional quality of life. Additionally, early recognition and careful intervention help minimize complications and provide long-lasting light relief for those affected.
Ready to Breathe Freely Again?
By Dr. Ben Cilento, ENT
May 18, 2025
