[Indomethacin-sensitive variant of migrainous neuralgia]

A 47-year-old woman had been suffering for 6 years from attacks of the most severe headaches lasting 4 to 6 days and occurring once or twice a month. The principal clinical manifestations of the disorder permitted its qualification as migrainous neuralgia. A unique characteristic of regularly occurring cephalgic attacks consisted in the constant alternation of suddenly developing and equally rapid-disappearing algetic episodes lasting 25-40 sec with cephalgia-free periods of 20-25 seconds. In interictal periods, momentary fulgurant pains in the right half of the head occurred during sharp turns of the neck. The administration of indomethacin in a dose of 50-75 mg daily was followed by a dramatic therapeutic response. The case described was identical to cases of Horton's syndrome differentiated by Sjaastad and Dale as an individual disease entity called "chronic paroxysmal migrainous neuralgia".