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Paroxysmal hemicrania responding to topiramate
1Headache Group, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
BMJ Case Reports
|July 8, 2011
Summary
Chronic paroxysmal hemicrania (CPH), a rare headache disorder, may be effectively treated with topiramate. This medication offers an alternative for patients experiencing side effects from indomethacin, a standard CPH treatment.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Chronic paroxysmal hemicrania (CPH) is a rare primary headache syndrome.
- CPH is classified as a trigeminal autonomic cephalalgia, alongside cluster headache and SUNCT.
- Indomethacin responsiveness is a key diagnostic criterion for CPH.
Purpose of the Study:
- To report a case of CPH successfully treated with topiramate.
- To explore topiramate as a potential treatment option for CPH patients intolerant to indomethacin.
Main Methods:
- A case study of a patient with CPH is presented.
- The patient experienced significant epigastric symptoms with indomethacin.
- Treatment with topiramate 150 mg daily was initiated and monitored.
Main Results:
- The patient responded well to topiramate treatment.
- Discontinuation of topiramate led to the recurrence of CPH episodes.
- The therapeutic effect of topiramate persisted for 2 years.
Conclusions:
- Topiramate may serve as a viable treatment alternative for chronic paroxysmal hemicrania.
- This finding is particularly relevant for patients who cannot tolerate indomethacin due to adverse effects.
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