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Hemicrania continua: diagnostic criteria and nosologic status
J A Pareja1, M Vincent, F Antonaci
1Hospital Ruber Internacional, Servicio de Neurología, Madrid, Spain. jpg03m@nacom.es
Cephalalgia : an International Journal of Headache
|March 21, 2002
Summary
This study proposes diagnostic criteria for hemicrania continua (HC), defining a typical form (HC vera) and an undetermined form (HC generis incerti). Both are characterized by unilateral pain and response to indomethacin.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Hemicrania continua (HC) is a primary headache disorder with specific clinical features.
- Establishing clear diagnostic criteria and nosological status for HC is essential for accurate diagnosis and treatment.
Purpose of the Study:
- To propose diagnostic criteria for hemicrania continua (HC).
- To define the nosological status of HC within headache classifications.
- To differentiate typical HC from similar headache presentations.
Main Methods:
- Clinical observation and analysis of symptom constellations.
- Evaluation of response to indomethacin treatment ('indotest').
- Comparative analysis with other headache disorders like chronic paroxysmal hemicrania (CPH) and cluster headache.
Main Results:
- HC is characterized by unilateral, non-shifting pain, absolute indomethacin responsiveness, and long-lasting repetitive attacks.
- Proposed term 'hemicrania continua vera' for typical HC with a positive 'indotest'.
- Proposed term 'hemicrania generis incerti' for 'indotest-negative' presentations, diagnosed by exclusion.
Conclusions:
- HC can be classified with CPH due to their shared absolute indomethacin responsiveness.
- A loose association is suggested between HC/CPH and cluster headache.
- Further research is needed to clarify the interrelationships between these headache types.