Is there need to search for alternatives to indomethacin for hemicrania continua? Case reports and a review

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Sanjay Prakash1, Mahammed Husain, Dhara S Sureka

  • 1Department of Neurology, Medical College, SSG Hospital, Baroda, Gujarat 390001, India. drprakashs@yahoo.co.in

Journal of the Neurological Sciences
|December 2, 2008
PubMed

Insights

Hemicrania continua (HC) is a challenging headache disorder. Topiramate shows promise as an alternative treatment for patients intolerant to indomethacin, offering relief from severe head pain.

Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Hemicrania continua (HC) is characterized by continuous unilateral headaches with superimposed severe exacerbations and autonomic features.
  • Indomethacin responsiveness is key to HC diagnosis, but significant side effects limit its use.
  • Managing HC requires exploring alternatives due to indomethacin's adverse effects and the chronic nature of the condition.

Observation:

  • This study reports two cases of Hemicrania continua successfully managed with topiramate.
  • Topiramate provided significant relief in patients experiencing severe head pain and autonomic symptoms.

Findings:

  • Topiramate is a viable alternative treatment for Hemicrania continua, particularly for individuals intolerant to indomethacin.
  • The findings suggest topiramate can effectively manage the debilitating symptoms of HC.

Implications:

  • Topiramate offers a new therapeutic option for Hemicrania continua patients, improving quality of life.
  • Further research into topiramate and other indomethacin alternatives is warranted for long-term HC management.

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