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Paroxysmal Hemicrania.

Chinar Osman1, Anish Bahra2

  • 1Wessex Neurological Centre, Southhampton General Hospital, Southhampton, England.

Annals of Indian Academy of Neurology
|May 4, 2018
PubMed
Summary
This summary is machine-generated.

Paroxysmal hemicrania (PH) is a rare headache disorder characterized by severe, one-sided pain and autonomic symptoms. It is uniquely responsive to indomethacin, offering effective treatment for this challenging condition.

Keywords:
Indomethacinparoxysmal hemicraniatrigeminal autonomic cephalalgias

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Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Paroxysmal hemicrania (PH) is a primary headache disorder within the trigeminal autonomic cephalalgias (TACs) group.
  • It presents as intense, unilateral headaches, predominantly in the ophthalmic trigeminal nerve distribution (V1), accompanied by ipsilateral cranial autonomic symptoms.

Purpose of the Study:

  • To review the epidemiology, clinical presentation, pathophysiology, evaluation, and treatment of Paroxysmal hemicrania.
  • To highlight the diagnostic significance of indomethacin responsiveness in distinguishing PH from other TACs.

Main Methods:

  • Literature review of studies on Paroxysmal hemicrania.
  • Analysis of clinical features, diagnostic criteria, and treatment outcomes.
  • Examination of neuroimaging findings, particularly posterior hypothalamic activation.

Main Results:

  • PH is characterized by exquisite sensitivity to indomethacin, serving as a key diagnostic and therapeutic marker.
  • The disorder can be chronic, necessitating long-term indomethacin management.
  • Pathophysiology involves hypothalamic and trigeminovascular mechanisms, supported by neuroimaging evidence.

Conclusions:

  • Early recognition and treatment of PH with indomethacin are crucial for effective management.
  • Understanding the unique features of PH aids in avoiding ineffective treatments for other primary headache disorders.
  • Continued research into TACs, including PH, is essential for refining therapeutic strategies.