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Hemicrania Continua
Aka: Hemicrania Continua
- See Also
- Cluster Headache
- Paroxysmal Hemicrania
- Short-Lasting Unilateral Neuralgiform Headache Attacks with Conjunctival Injection or Tearing (SUNCT Headache)
- Headache
- Headache Red Flag
- Organic Headache
- Chronic Daily Headache
- Classification
- Long duration
- Trigeminal Autonomic Cephalgia
- Headaches similar to Cluster Headache
- Unilateral trigeminal distribution symptoms with autonomic features
- Symptoms
- Characteristics
- Unilateral Headache
- Associated symptoms (at least one of the following cluster-like autonomic findings)
- Conjunctival injection or Lacrimation
- Nasal congestion or Rhinorrhea
- Ptosis or Miosis
- Palliative measures
- Responds completely to Indomethacin
- Imaging
- MRI Brain with and without contrast
- Recommended for all Trigeminal Autonomic Cephalalgia including Cluster Headaches
- Obtain even if no other Headache Red Flag present
- Diagnosis
- Unilateral Headache of moderate or greater severity Headaches for at least 3 months
- At least of the following (ipsilateral to the Headache, other than restlessness)
- Conjunctival injection or Lacrimation
- Nasal congestion or Rhinorrhea
- Eyelid Edema
- Forehead and facial sweating
- Miosis or Ptosis
- Restlessness or Agitation
- Responds to therapeutic doses of Indomethacin
- Indomethacin 150 to 225 in divided doses per day
- Timing
- Remitting
- Remission periods of >24 hours
- Unremitting
- Daily and continuous Headache >1 year without remission periods >24 hours
- References
- (2018) Cephalgia 38(1):1-211 [PubMed]
- Differential Diagnosis
- See Cluster Headache
- Management
- Indomethacin
- References
- (2004) Cephalgia 24(suppl 1): 9-160 [PubMed]
- Yancey (2014) Am Fam Physician 89(8): 642-8 [PubMed]