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Hemicrania continua: attacks may alternate sides
L C Newman1, R B Lipton, M Russell
1Department of Neurology, Albert Einstein College of Medicine, Bronx, New York.
Insights
Hemicrania continua (HC) typically presents as continuous unilateral headaches. This case report details a rare presentation of HC with headaches alternating sides, challenging typical diagnostic criteria.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Hemicrania continua (HC) is a primary headache disorder defined by continuous unilateral pain.
- HC typically presents with moderate-intensity headaches that persist for years without remission or alternate between severe and moderate phases.
- Distinguishing HC from other cyclical headache disorders like episodic paroxysmal hemicrania is crucial.
Observation:
- This report describes a unique case of Hemicrania continua (HC).
- The patient experienced headaches that characteristically alternated sides.
- This presentation deviates from the typical unilateral, non-shifting headache pattern of HC.
Findings:
- The case highlights a rare variant of Hemicrania continua (HC).
- Headache side-alternation in HC challenges established diagnostic features.
- This atypical presentation necessitates a broader understanding of HC's clinical spectrum.
Implications:
- This case expands the recognized clinical spectrum of Hemicrania continua (HC).
- It underscores the importance of considering atypical presentations in diagnosing HC.
- Further research may elucidate the mechanisms behind side-alternating HC headaches.
Abstract:
Hemicrania continua (HC) is characterized by a continuous unilateral headache of moderate severity, occurring in 2 patterns; a continuous form in which headaches persist continuously without remission for years, and a remitting form, consisting of headache phases separated by periods of pain-free remission. The remitting form of HC must be distinguished from other cyclical headache disorders such as episodic paroxysmal hemicrania and episodic cluster headache. Characteristically, the headache of HC is unilateral and without sideshift. We now report a case of HC in which headaches alternate sides.