Related Experiment Videos
Hemicrania continua and symptomatic medication overuse
1Temple University School of Medicine, Philadelphia, Pennsylvania.
Insights
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.
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.
Abstract:
Hemicrania continua (HC) is a rare, strictly unilateral, nonparoxysmal headache disorder characterized by its absolute responsiveness to indomethacin. The pain is usually moderate in intensity and frequently associated with a superimposed "jabs and jolts" headache. We report two cases of HC which presented as chronic daily headache (CDH) with abortive medication overuse. CDH can be due to transformed migraine (TM), new daily persistent headache (NDPH), chronic tension-type headache, and HC. All can be unilateral, and all can be associated with medication overuse. Our two cases meet the criteria for HC based on indomethacin responsiveness. One meets the criteria for TM, the other NDPH. Is HC a distinct disorder, or a subset of these other disorders? CDH with medication overuse includes in its differential diagnosis HC.