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Hemicrania continua with contralateral cranial autonomic features: a case report
Sanjay Prakash1, Chaturbhuj Rathore2, Prayag Makwana3
1Department of Neurology, Smt B. K. Shah Medical institute and research Centre Medical College, Piperia, Waghodia, Vadodara, Gujarat, 391760, India. drprakashs@yahoo.co.in.
The Journal of Headache and Pain
|April 24, 2015
Summary
Hemicrania continua, a type of headache, typically presents with one-sided pain and autonomic symptoms on the same side. This case highlights unusual contralateral autonomic features during exacerbations, responding fully to indomethacin.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Hemicrania continua is a continuous, strictly unilateral headache.
- Exacerbations are usually accompanied by ipsilateral cranial autonomic features.
Observation:
- A 24-year-old female presented with a 2-year history of right-sided headache with exacerbations.
- Exacerbations involved marked agitation and contralateral cranial autonomic features.
Findings:
- The patient experienced a complete response to indomethacin within 8 hours.
- This case presents an unusual contralateral pattern of autonomic features during hemicrania continua exacerbations.
Implications:
- The observed dichotomy suggests separate neural pathways for pain and autonomic features in trigeminal autonomic cephalalgias.
- This finding may refine our understanding of the pathophysiology of hemicrania continua and related disorders.
