Hemicrania Continua

What is Hemicrania Continua?

Hemicrania continua is a rare form of chronic headache marked by continuous pain on one side of the face that varies in severity. Superimposed on the continuous but fluctuating pain are occasional attacks of more severe pain. Symptoms fall into two main categories: autonomic, including runny nose, tearing, eye redness, eye discomfort, sweating, and swollen and drooping eyelids; and migraine-like, including nausea, vomiting, and sensitivity to light and sound. The disorder has two forms: continuous, with daily headaches, and remitting, where headaches may occur for as long as 6 months and are followed by a pain-free period of weeks to months until they recur. Most patients experience attacks of increased pain three to five times per 24-hour cycle. This disorder is more common in women than in men. Physical exertion and alcohol use may increase the severity of headache pain in some patients. The cause of this disorder is unknown.

Is there any treatment?

Indomethacin, a non-steroidal anti-inflammatory drug (NSAID), usually provides rapid relief from symptoms.

Other NSAIDs, including ibuprofen, celecoxib, and naproxen, can provide some relief from symptoms. Amitriptyline and other tricyclic antidepressants are effective in some patients.

What is the prognosis?

Patients may obtain complete to near-complete relief of symptoms with proper medical attention and daily medication. Some patients may not be able to tolerate long-term use of indomethacin and may have to rely on less effective NSAIDs.