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Updated: Jun 2, 2026
10:39
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
[A woman with unilateral headache]
Kai Ivar Müller1, Svein Ivar Bekkelund
1Nevrologisk avdeling, Universitetssykehuset Nord-Norge, 9038 Tromsø, Norway. kai.ivar.muller@unn.no
Summary
This case highlights diagnostic challenges in unilateral headaches, specifically chronic paroxysmal hemicrania (CPH). Prompt diagnosis and appropriate treatment, like indomethacin, are crucial for effective management.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Unilateral headaches present diagnostic challenges, often leading to delayed or incorrect diagnoses.
- Chronic paroxysmal hemicrania (CPH) is a rare headache disorder characterized by severe, unilateral attacks.
Observation:
- A patient with a 15-year history of unilateral headaches presented with side-locked paroxysmal attacks.
- Initial examinations and MRI were normal; she responded to indomethacin but experienced dyspepsia.
- Delayed diagnosis of CPH occurred due to non-compliance and misdiagnoses.
Findings:
- Indomethacin was effective, but rectal administration was needed due to dyspepsia.
- Rofecoxib also provided complete relief, suggesting broader treatment options.
- Ipsilateral cranial autonomic symptoms supported a hemicrania diagnosis.
Implications:
- This case underscores the clinical controversies and difficulties in diagnosing and treating unilateral headaches like CPH.
- Highlights the importance of considering CPH in refractory unilateral headache presentations.
- Emphasizes the need for timely diagnosis and appropriate therapeutic interventions to improve patient outcomes.
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