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Ipsilateral cluster headache and chronic paroxysmal hemicrania: two case reports
A D Tehindrazanarivelo1, J M Visy, M G Bousser
1Service de Neurologie, Hôpital Saint Antoine, Paris, France.
Cephalalgia : an International Journal of Headache
|October 1, 1992
Summary
Cluster headache and chronic paroxysmal hemicrania share similarities but are distinct. Effective treatment for both conditions may involve a combination of indomethacin and verapamil.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Cluster headache and chronic paroxysmal hemicrania are distinct primary headache disorders.
- Both conditions present with severe, unilateral head pain, often accompanied by autonomic symptoms.
Observation:
- Two patients presented with sequential or concurrent attacks of both cluster headache and chronic paroxysmal hemicrania.
- Patient 1 experienced a transition from cluster headache to chronic paroxysmal hemicrania, requiring both indomethacin and verapamil for symptom control.
- Patient 2 initially responded to verapamil for cluster headache, but chronic paroxysmal hemicrania worsened, necessitating the addition of indomethacin.
Findings:
- The cases suggest a complex relationship between cluster headache and chronic paroxysmal hemicrania.
- Indomethacin demonstrated efficacy in treating chronic paroxysmal hemicrania, while verapamil was effective for cluster headache.
- Combined therapy with indomethacin and verapamil provided relief when individual treatments were insufficient.
Implications:
- These findings highlight the importance of accurate differential diagnosis between cluster headache and chronic paroxysmal hemicrania.
- The study underscores the potential benefit of combination pharmacotherapy in managing patients with overlapping or sequential headache presentations.
- Further research is warranted to elucidate the underlying pathophysiology linking these two headache disorders.