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Hemicrania continua in African Americans
1Ryan Wheeler Headache Treatment Center, Miami, Florida 33189, USA. DrHeadache@aol.com
Journal of the National Medical Association
|November 1, 2002
Summary
Hemicrania continua, a chronic daily headache, is reported in African Americans for the first time. Misdiagnosis is likely more common than true rarity in this population.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Hemicrania continua is a chronic daily headache responsive to indomethacin.
- Characterized by constant, unilateral, fluctuating mild to moderate headache with superimposed severe attacks.
- Attacks include ipsilateral orbital-nasal autonomic dysfunction.
Observation:
- The first six cases in African Americans are presented.
- Severe attacks were pulsatile, lasting 40 minutes to 3 days, occurring 1-4 times daily.
- Background headache varied in quality; autonomic symptoms were universal.
Findings:
- African American patients exhibited late onset, frequent comorbidities (e.g., cardiovascular disease, diabetes, hypertension), and a family history of migraine.
- This series differs from previous reports in these aspects.
- The rarity in literature is attributed to misdiagnosis rather than low prevalence.
Implications:
- Highlights the importance of assessing for autonomic symptoms in chronic unilateral headaches.
- Suggests considering an indomethacin trial for suspected cases.
- Emphasizes the need for increased awareness and accurate diagnosis in African Americans.