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Update on hemicrania continua

Elisabetta Cittadini1, Peter J Goadsby

  • 1Functional Magnetic Resonance Imaging of the Brain Centre, Pain Group, Oxford University, Oxford, UK. cittadin@fmrib.ox.ac.uk

Current Pain and Headache Reports
|November 17, 2010
PubMed

Insights

Hemicrania continua (HC) is a rare headache syndrome with unilateral pain, uniquely responding to indometacin. Research highlights its distinct subcortical brain involvement, supporting its classification as a separate entity.

Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Hemicrania continua (HC) is a rare primary headache disorder.
  • First described in 1984, over 100 cases are documented globally.
  • Recent case series reveal complex clinical presentations of HC.

Purpose of the Study:

  • To characterize the unique clinical presentation and neurobiological underpinnings of Hemicrania continua.
  • To support the classification of HC as a distinct headache entity.

Main Methods:

  • Review of clinical case series.
  • Analysis of functional imaging studies investigating subcortical brain activity.

Main Results:

  • HC presents with unilateral pain and a complete response to indometacin.
  • Functional imaging reveals specific subcortical involvement: contralateral posterior hypothalamus, ipsilateral dorsal pons, and ipsilateral ventral midbrain.
  • These findings, combined with indometacin's efficacy, suggest HC is a unique neurological entity.

Conclusions:

  • Hemicrania continua is a distinct primary headache syndrome.
  • Its unique clinical features and neurobiological profile, particularly hypothalamic and brainstem involvement, differentiate it from other headaches.
  • Increased clinical awareness is crucial for accurate diagnosis and management of HC.

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