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Published on: June 2, 2014
Focus on therapy: hemicrania continua and new daily persistent headache
Paolo Rossi1, Cristina Tassorelli, Marta Allena
1Headache Clinic INI Grottaferrata, Rome, Italy.
The Journal of Headache and Pain
|February 27, 2010
Summary
Hemicrania continua (HC) is effectively managed with indomethacin, while new daily-persistent headache (NDPH) remains challenging to treat. This review offers evidence-based management strategies for these rare chronic daily headaches.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Hemicrania continua (HC) and new daily-persistent headache (NDPH) are rare primary chronic daily headaches.
- Their pathophysiology is poorly understood, leading to empirical management strategies.
- Limited high-quality evidence exists due to a lack of controlled trials.
Purpose of the Study:
- To review and synthesize current literature on the treatment of HC and NDPH.
- To provide evidence-based recommendations for managing these rare headache disorders.
- To address the empirical nature of current treatment approaches.
Main Methods:
- Narrative literature review.
- Extensive analysis of published studies on HC and NDPH treatments.
- Synthesis of data from open-label trials, case series, and expert opinions.
Main Results:
- Indomethacin is the primary treatment for HC, with effective doses ranging from 50-300 mg/day.
- Alternative options for HC include gabapentin, topiramate, and celecoxib for intolerant or contraindicated patients.
- NDPH is difficult to treat and shows poor response to standard migraine or tension-type headache therapies.
Conclusions:
- Indomethacin remains the cornerstone for HC management.
- Effective treatment options for NDPH are limited and require further research.
- Evidence-based guidelines are crucial for optimizing the management of these rare headaches.
