II. Classification
- Short duration
- Trigeminal Autonomic Cephalgia
- Headaches similar to Cluster Headache
- Unilateral trigeminal distribution symptoms with autonomic features
III. Symptoms
- Severity
- Severe pain
- Characteristics
- Unilateral orbital, supraorbital or temporal Headache
- Timing
- Duration of 2-30 minutes
- Recurs more than 5 times daily on >50% of days
- Palliative
- Relieved with Indomethacin (unlike Cluster Headaches which are not relieved with Indomethacin)
- Associated Symptoms (at least one of the following autonomic symptoms characteristic of Cluster Headaches)
- Lacrimation
- Ipsilateral forehead or facial Flushing or sweating
- Ipsilateral Nasal Discharge
- Affected eye red with dilated Conjunctival vessels (Conjunctival injection)
- Restlessness, pacing or rocking head in hands
- Horner's Syndrome (30% of cases)
IV. Diagnosis
- Characteristics: At least 20 or more Headaches meeting the following criteria
- Severe to very severe unilateral orbital, supraorbital or temporal pain lasting 2-30 minutes
- Headaches >5 times daily
- Prevented by therapeutic Indomethacin doses 150 to 225 mg in divided dosing per day
- Headache with at least one of the following ipsilateral autonomic symptoms
- Conjunctival injection or Lacrimation
- Nasal congestion or Rhinorrhea
- Eyelid Edema
- Forehead and facial sweating
- Miosis or Ptosis
- Restlessness or Agitation
- Timing
- Episodic
- Two or more cluster periods lasting 7-365 days and separated by pain-free remissions >3 month
- Chronic
- Episodes recur for more than 1 year without remission or with remission <3 month
- Episodic
- References
V. Differential Diagnosis
- See Cluster Headache
VI. Management
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| Definition (MSH) | A primary headache disorder that is similar to the CLUSTER HEADACHE with unilateral head pain, but differs by its multiple short severe attacks. It is usually seen in females, and may be responsive to non-steroidal-anti-inflammatory drugs (NSAIDS). |
| Concepts | Disease or Syndrome (T047) |
| MSH | D051302 |
| ICD10 | G44.03 |
| SnomedCT | 443094001 |
| Swedish | Paroxysmal hemikrani |
| Czech | paroxysmální hemikranie, paroxyzmální hemikranie |
| Finnish | Kohtauksittainen migreeni |
| Russian | GEMIKRANIIA PAROKSIZMAL'NAIA, ГЕМИКРАНИЯ ПАРОКСИЗМАЛЬНАЯ |
| English | paroxysmal hemicrania (diagnosis), paroxysmal hemicrania, Paroxysmal hemicrania, Paroxysmal hemicrania (disorder), Paroxysmal hemicrania NOS, Paroxysmal Hemicrania [Disease/Finding], Paroxysmal hemicrania (headache one side of head), hemicrania; paroxysmal, paroxysmal; hemicrania, Hemicranias, Paroxysmal, Paroxysmal Hemicranias, Paroxysmal Hemicrania, Hemicrania, Paroxysmal |
| Spanish | hemicránea paroxística (trastorno), hemicránea paroxística, Hemicránea Paroxística |
| Polish | Hemikrania napadowa |
| Japanese | 発作性片頭痛-慢性, 片頭痛-反復性発作性, 発作性片頭痛, 発作性片頭痛-反復性, 発作性片側頭痛, 反復性発作性片側頭痛, 反復性発作性片頭痛, 片頭痛-発作性-反復性, 片頭痛-発作性-慢性, 慢性発作性片頭痛, 慢性発作性片側頭痛, 片頭痛-発作性 |
| Norwegian | Paroksysmal hemikrani |
| Portuguese | Enxaqueca Paroxística, Hemicrania Paroxística |
| Dutch | hemicrania; paroxysmaal, paroxysmaal; hemicrania |
| German | Paroxysmale Hemikranie |
| Italian | Emicrania parossistica |
| French | Hémicrânie paroxystique |
