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Hemicrania continua responsive to botulinum toxin type a: a case report
1Department of Neurology, Hull Royal Infirmary, Kingston-upon-Hull, UK.
Insights
Hemicrania continua (HC) is a rare headache disorder. Botulinum toxin type A effectively treated a patient with HC who experienced side effects from indomethacin, offering a new therapeutic option.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Hemicrania continua (HC) is a primary headache disorder.
- Indomethacin is a diagnostic criterion for HC due to its efficacy.
- Indomethacin's side effects can limit its use in managing HC.
Observation:
- A case of a 33-year-old female patient with HC is presented.
- The patient experienced gastric side effects from indomethacin.
- Standard pharmacological treatments were ineffective for the patient's HC.
Findings:
- Botulinum toxin type A injection resulted in complete resolution of the patient's HC symptoms.
- This suggests a potential alternative treatment for refractory HC cases.
Implications:
- Botulinum toxin type A may be a viable therapeutic option for patients with Hemicrania continua who cannot tolerate indomethacin.
- Further research into the neurobiological mechanisms underlying botulinum toxin's efficacy in HC is warranted.
Background:
Hemicrania continua (HC) is a primary headache disorder with full response to indomethacin as one of its diagnostic criteria; however, indomethacin's side effects could limit its use in HC.
Case Result:
We report a 33-year-old lady whose headache fulfilled the criteria for HC, but the patient developed gastric side effect to indomethacin and did not respond to other pharmacological treatments; however, injecting botulinum toxin type A has led to complete resolution of all of her symptoms.
Discussion:
We hypothesize the mechanism by which botulinum toxin type A has led to our results through reviewing recent functional neuroimaging findings used to understand the pathophysiology of different primary headache disorders.
