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Misdiagnosis of hemicrania continua

Mario F P Peres1, Marcelo M Valença, André Leite Gonçalves

  • 1UNIFESP (Universidade Federal de São Paulo), São Paulo, Brazil. marioperes@yahoo.com

Expert Review of Neurotherapeutics
|September 23, 2009
PubMed

Insights

Hemicrania continua (HC) is an under-recognized headache disorder, often misdiagnosed. Prompt recognition and treatment with indomethacin are crucial for managing this continuous unilateral headache syndrome.

Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Hemicrania continua (HC) is a primary headache disorder.
  • It presents as a continuous, unilateral headache of moderate intensity with severe pain exacerbations.
  • Misdiagnosis is common in clinical practice.

Purpose of the Study:

  • To bridge the diagnostic gap for Hemicrania continua.
  • To highlight HC as an under-recognized headache syndrome.
  • To discuss diagnostic criteria and treatment options.

Main Methods:

  • Review of existing literature on Hemicrania continua.
  • Analysis of clinical characteristics and diagnostic challenges.
  • Evaluation of treatment responses, particularly to indomethacin.

Main Results:

  • HC is characterized by continuous unilateral pain and complete response to indomethacin.
  • It is more common than previously thought and often misdiagnosed.
  • Variants like HC with aura exist, and secondary causes may occur.

Conclusions:

  • Accurate diagnosis of Hemicrania continua is essential.
  • Indomethacin remains the gold standard treatment.
  • Increased awareness can improve patient outcomes for this under-recognized headache disorder.

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