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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
10:39

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Hemicrania continua: major shortcomings in the new classification

Torbjørn A Fredriksen, Fabio Antonaci, Ottar Sjaastad1

  • 1Department of Neurosurgery, St, Olavs Hospital, Trondheim University Hospitals, Trondheim, Norway. ellhed@online.no.

The Journal of Headache and Pain
|September 14, 2014
PubMed

Insights

Hemicrania continua (HC) diagnostic criteria require revision. Current classifications incorrectly identify cases and mandate excessive indomethacin dosages, necessitating an urgent update to diagnostic standards.

Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Hemicrania continua (HC) was initially defined by Sjaastad and Spierings in 1984.
  • Subsequent cases should align with this original description.

Discussion:

  • The International Classification of Headache Disorders (ICHD) 3rd edition beta version presents significant flaws in its HC criteria.
  • These proposed criteria include rare symptoms as obligatory and recommend excessively high indomethacin dosages.
  • This leads to the systematic misdiagnosis of Hemicrania continua.

Key Insights:

  • Current diagnostic criteria for Hemicrania continua are inadequate.
  • The proposed ICHD-3 beta criteria for HC are flawed, leading to misdiagnosis.
  • Recommended indomethacin dosages in the criteria are unacceptably high.

Outlook:

  • A major revision of the current diagnostic system for Hemicrania continua is urgently needed.
  • Revised criteria should accurately reflect typical HC presentations and appropriate treatment dosages.

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