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Hemicrania continua and symptomatic medication overuse

W B Young1, S D Silberstein

  • 1Temple University School of Medicine, Philadelphia, Pennsylvania.

Headache
|October 1, 1993
PubMed
Summary

Hemicrania continua (HC), a rare unilateral headache, is uniquely responsive to indomethacin. This study explores HC within the spectrum of chronic daily headaches, questioning its distinctness from other headache types.

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Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Hemicrania continua (HC) is a rare, strictly unilateral headache disorder.
  • It is characterized by absolute responsiveness to indomethacin and often presents with superimposed jabs and jolts.
  • Chronic daily headache (CDH) encompasses various headache types, including transformed migraine (TM), new daily persistent headache (NDPH), and chronic tension-type headache.

Observation:

  • Two cases of HC presented as CDH with medication overuse.
  • Both cases met HC criteria due to indomethacin responsiveness.
  • One case also met criteria for TM, and the other for NDPH.

Findings:

  • HC shares features with other CDH types, including unilaterality and association with medication overuse.
  • The differential diagnosis of CDH with medication overuse must include HC.
  • The distinctness of HC as a separate disorder is questioned in the context of CDH.

Implications:

  • Accurate diagnosis of HC is crucial for effective treatment, particularly with indomethacin.
  • Understanding HC's place within CDH broadens diagnostic considerations.
  • Further research is needed to clarify the relationship between HC and other chronic daily headache disorders.

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