Ectopic tooth: an unusual cause of headache

A 27-year-old woman was referred to neurology from her family physician's office for evaluation of her seizures. The patient also had chronic headaches that were refractory to standard medical treatment. She described these as unilateral, throbbing, of moderate to severe intensity, and accompanied by nausea and photophobia. A neurological examination was unremarkable. Migraine without aura was considered the most likely diagnosis; however, because the headaches were treatment resistant, they ordered computed tomography of the head and sinuses. The imaging showed a hyperdensity obstructing the right maxillary sinus, most in keeping with an ectopic tooth. They diagnosed sinusitis and consulted otolaryngology for potential surgical intervention. The tooth was extracted under general anesthesia, without complication. The patient's headaches have now entirely abated. The authors have described an uncommon case of an ectopic maxillary tooth presenting with features of migraine without aura.