Hemicrania continua: Difference between revisions
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{{Infobox medical condition | |||
| name = Hemicrania continua | |||
| synonyms = | |||
| field = [[Neurology]] | |||
| symptoms = [[Unilateral headache]], [[autonomic symptoms]] | |||
| onset = | |||
| duration = | |||
| types = | |||
| causes = Unknown | |||
| risks = | |||
| diagnosis = Clinical evaluation, response to [[indomethacin]] | |||
| differential = [[Migraine]], [[cluster headache]], [[tension-type headache]] | |||
| treatment = [[Indomethacin]] | |||
| medication = | |||
| frequency = | |||
| deaths = | |||
}} | |||
{{Short description|A primary headache disorder characterized by continuous, unilateral pain}} | {{Short description|A primary headache disorder characterized by continuous, unilateral pain}} | ||
{{Use dmy dates|date=October 2023}} | {{Use dmy dates|date=October 2023}} | ||
'''Hemicrania continua''' is a rare [[primary headache disorder]] characterized by continuous, unilateral [[headache]] that varies in intensity but does not resolve completely. It is classified under the group of [[trigeminal autonomic cephalalgias]] and is known for its responsiveness to [[indomethacin]], a nonsteroidal anti-inflammatory drug. | '''Hemicrania continua''' is a rare [[primary headache disorder]] characterized by continuous, unilateral [[headache]] that varies in intensity but does not resolve completely. It is classified under the group of [[trigeminal autonomic cephalalgias]] and is known for its responsiveness to [[indomethacin]], a nonsteroidal anti-inflammatory drug. | ||
==Clinical Features== | ==Clinical Features== | ||
Hemicrania continua is defined by its persistent nature, with patients experiencing a continuous headache on one side of the head. The pain can fluctuate in intensity, with periods of exacerbation that may include additional symptoms such as: | Hemicrania continua is defined by its persistent nature, with patients experiencing a continuous headache on one side of the head. The pain can fluctuate in intensity, with periods of exacerbation that may include additional symptoms such as: | ||
* [[Nausea]] | * [[Nausea]] | ||
* [[Photophobia]] (sensitivity to light) | * [[Photophobia]] (sensitivity to light) | ||
* [[Phonophobia]] (sensitivity to sound) | * [[Phonophobia]] (sensitivity to sound) | ||
* [[Autonomic symptoms]] such as tearing, nasal congestion, or ptosis on the affected side | * [[Autonomic symptoms]] such as tearing, nasal congestion, or ptosis on the affected side | ||
The condition is unique in its absolute response to indomethacin, which is a key diagnostic criterion. | The condition is unique in its absolute response to indomethacin, which is a key diagnostic criterion. | ||
==Diagnosis== | ==Diagnosis== | ||
The diagnosis of hemicrania continua is primarily clinical, based on the characteristic symptoms and the patient's response to indomethacin. The International Classification of Headache Disorders (ICHD) provides criteria that include: | The diagnosis of hemicrania continua is primarily clinical, based on the characteristic symptoms and the patient's response to indomethacin. The International Classification of Headache Disorders (ICHD) provides criteria that include: | ||
* Unilateral headache for more than three months | * Unilateral headache for more than three months | ||
* Complete resolution of headache with indomethacin | * Complete resolution of headache with indomethacin | ||
* Presence of at least one autonomic symptom during exacerbations | * Presence of at least one autonomic symptom during exacerbations | ||
==Pathophysiology== | ==Pathophysiology== | ||
The exact pathophysiology of hemicrania continua is not well understood. It is believed to involve dysfunction in the [[trigeminal nerve]] pathways and possibly the [[hypothalamus]], similar to other trigeminal autonomic cephalalgias. The role of indomethacin suggests an inflammatory component, although the precise mechanisms remain unclear. | The exact pathophysiology of hemicrania continua is not well understood. It is believed to involve dysfunction in the [[trigeminal nerve]] pathways and possibly the [[hypothalamus]], similar to other trigeminal autonomic cephalalgias. The role of indomethacin suggests an inflammatory component, although the precise mechanisms remain unclear. | ||
==Treatment== | ==Treatment== | ||
The hallmark of hemicrania continua treatment is the use of indomethacin, which typically provides complete relief of symptoms. The dosage of indomethacin may vary, and it is often started at a low dose and gradually increased until the headache is controlled. Long-term use of indomethacin can have side effects, so patients are monitored closely. | The hallmark of hemicrania continua treatment is the use of indomethacin, which typically provides complete relief of symptoms. The dosage of indomethacin may vary, and it is often started at a low dose and gradually increased until the headache is controlled. Long-term use of indomethacin can have side effects, so patients are monitored closely. | ||
In cases where indomethacin is not tolerated, alternative treatments may include other nonsteroidal anti-inflammatory drugs, [[gabapentin]], or [[topiramate]], although these are generally less effective. | In cases where indomethacin is not tolerated, alternative treatments may include other nonsteroidal anti-inflammatory drugs, [[gabapentin]], or [[topiramate]], although these are generally less effective. | ||
==Prognosis== | ==Prognosis== | ||
With appropriate treatment, the prognosis for individuals with hemicrania continua is generally good. Most patients experience significant relief from symptoms with indomethacin. However, the condition is chronic and may require long-term management. | With appropriate treatment, the prognosis for individuals with hemicrania continua is generally good. Most patients experience significant relief from symptoms with indomethacin. However, the condition is chronic and may require long-term management. | ||
==Related Pages== | ==Related Pages== | ||
* [[Trigeminal autonomic cephalalgias]] | * [[Trigeminal autonomic cephalalgias]] | ||
| Line 37: | Line 44: | ||
* [[Chronic daily headache]] | * [[Chronic daily headache]] | ||
* [[Cluster headache]] | * [[Cluster headache]] | ||
[[Category:Headaches]] | [[Category:Headaches]] | ||
[[Category:Neurological disorders]] | [[Category:Neurological disorders]] | ||
Latest revision as of 23:58, 3 April 2025
| Hemicrania continua | |
|---|---|
| Synonyms | |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Unilateral headache, autonomic symptoms |
| Complications | N/A |
| Onset | |
| Duration | |
| Types | |
| Causes | Unknown |
| Risks | |
| Diagnosis | Clinical evaluation, response to indomethacin |
| Differential diagnosis | Migraine, cluster headache, tension-type headache |
| Prevention | N/A |
| Treatment | Indomethacin |
| Medication | |
| Prognosis | N/A |
| Frequency | |
| Deaths | |
A primary headache disorder characterized by continuous, unilateral pain
Hemicrania continua is a rare primary headache disorder characterized by continuous, unilateral headache that varies in intensity but does not resolve completely. It is classified under the group of trigeminal autonomic cephalalgias and is known for its responsiveness to indomethacin, a nonsteroidal anti-inflammatory drug.
Clinical Features[edit]
Hemicrania continua is defined by its persistent nature, with patients experiencing a continuous headache on one side of the head. The pain can fluctuate in intensity, with periods of exacerbation that may include additional symptoms such as:
- Nausea
- Photophobia (sensitivity to light)
- Phonophobia (sensitivity to sound)
- Autonomic symptoms such as tearing, nasal congestion, or ptosis on the affected side
The condition is unique in its absolute response to indomethacin, which is a key diagnostic criterion.
Diagnosis[edit]
The diagnosis of hemicrania continua is primarily clinical, based on the characteristic symptoms and the patient's response to indomethacin. The International Classification of Headache Disorders (ICHD) provides criteria that include:
- Unilateral headache for more than three months
- Complete resolution of headache with indomethacin
- Presence of at least one autonomic symptom during exacerbations
Pathophysiology[edit]
The exact pathophysiology of hemicrania continua is not well understood. It is believed to involve dysfunction in the trigeminal nerve pathways and possibly the hypothalamus, similar to other trigeminal autonomic cephalalgias. The role of indomethacin suggests an inflammatory component, although the precise mechanisms remain unclear.
Treatment[edit]
The hallmark of hemicrania continua treatment is the use of indomethacin, which typically provides complete relief of symptoms. The dosage of indomethacin may vary, and it is often started at a low dose and gradually increased until the headache is controlled. Long-term use of indomethacin can have side effects, so patients are monitored closely. In cases where indomethacin is not tolerated, alternative treatments may include other nonsteroidal anti-inflammatory drugs, gabapentin, or topiramate, although these are generally less effective.
Prognosis[edit]
With appropriate treatment, the prognosis for individuals with hemicrania continua is generally good. Most patients experience significant relief from symptoms with indomethacin. However, the condition is chronic and may require long-term management.
