"Hemicrania continua". An indomethacin responsive headache. II. Autonomic function studies

Area of Science:

• Neurology
• Autonomic Neuroscience

Background:

• Hemicrania continua is a newly described unilateral headache.
• Indomethacin is known to abort this headache type.

Purpose of the Study:

• To investigate autonomic parameters in hemicrania continua.
• To differentiate hemicrania continua from other headache types using pupillometry.

Main Methods:

• Studied autonomic parameters in two patients with hemicrania continua.
• Performed pupillometry before and after tyramine instillation.
• Assessed the effect of indomethacin medication.

Main Results:

• Patients presented with isocoria (equal pupils) when untreated.
• Bilateral tyramine instillation caused anisocoria (unequal pupils), with the smaller pupil on the headache side.
• Indomethacin treatment normalized pupillometry.

Conclusions:

• Pupillometric findings in hemicrania continua are distinct.
• These autonomic changes suggest a unique pathophysiology.
• Hemicrania continua differs from chronic paroxysmal hemicrania based on these pupillometric anomalies.