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Hemicrania continua: Some common triggers

Hemicrania continua is a kind of primary headache characterized by long-term discomfort on one side of the head.

Hemicrania continua is a primary headache, meaning it is not caused by another condition or disease. The pain usually lasts for more than a month and is punctuated by moments of extreme pain.

Chronic and remitting hemicrania are the two forms of hemicrania. Chronic hemicrania is characterized by persistent daily headaches. Remitting hemicrania is characterized by recurrent headaches that can last up to six months, followed by intervals of no symptoms.

The causes, symptoms, treatment, and outlook of hemicrania continua are discussed in the following article.

Causes and triggers

hemicrania continua

The specific cause of hemicrania continua is unknown, according to the National Institute of Neurological Disorders and Stroke.

According to the organization, two factors — alcohol use and physical effort — may cause pain to worsen in certain people with the condition. The Migraine Trust, on the other hand, points out that the cause of the condition is unknown.

Potential risk factors

Medical specialists know little about the risk factors for developing hemicrania continua, just as they know little about the triggers for the condition.

According to the Genetic and Rare Diseases Information Center, biological females are more likely than biological males to develop hemicrania continua. The condition is most commonly diagnosed in adults, but it can strike anyone between the ages of 5 and 67.

Treatment

Treatment for hemicrania continues primarily on prevention. There is no recognized treatment for the condition.

Indomethacin, a type of nonsteroidal anti-inflammatory medicine, is the most effective treatment (NSAID). To treat symptoms, a person must take 25–300 mg of indomethacin every day for an indeterminate amount of time.

In fact, indomethacin is so effective in the right doses that doctors may use it to diagnose the condition. In other words, an indomethacin-resistant headache is unlikely to be hemicrania continua.

Indomethacin is not suitable for everyone. A doctor may provide acid-suppression therapy to assist minimize gastrointestinal issues if the adverse effects are modest.

A doctor may also prescribe celecoxib, a nonsteroidal anti-inflammatory drug with less adverse effects.

Finally, amitriptyline or another tricyclic antidepressant may be prescribed by a doctor to assist prevent headache pain.

Symptoms

A dull, constant headache on one side of the head that lasts for days or weeks, perhaps even longer, is the most visible and common sign of hemicrania continua. Some people, though, may feel discomfort on both sides of their heads.

Additionally, a person may suffer throbbing pain on the same side of the head as the dull aching on occasion.

A person must have at least one of the following symptoms to be diagnosed with hemicrania continua:

  • eye redness or tearing
  • miosis (contracture of the iris)
  • nasal congestion
  • ptosis (drooping eyelid)
  • runny nose
  • restlessness or pain aggravated by movement

Some people may also suffer from sweating on the forehead and migraine-like symptoms such as:

  • vomiting
  • throbbing pain
  • light and sound sensitivity
  • nausea

Diagnosis 

The International Headache Society has developed precise diagnostic criteria for hemicrania continua.

A person must also have the following symptoms in addition to pain on only one side of the head:

  • an ongoing, dull headache for 3 or more months
  • a headache that gets better with therapeutic doses of indomethacin
  • at least one additional symptom, including runny nose, ptosis, nasal congestion, restlessness, miosis, or redness or tearing in the eye

Also, the headache and symptoms must not fulfill the criteria for any other type of headache or be better described by it.

When should you see a doctor?

A doctor cannot diagnose hemicrania continua unless the patient has had persistent pain for at least three months.

If the pain is dull and one-sided, a person should keep a headache log and see their doctor when the pain lasts more than three months.

If a person has a strong headache that is accompanied by a fever or other troubling symptoms, they should contact their doctor as soon as possible. A severe headache might be a symptom of a more serious health condition that necessitates emergency medical attention in some situations.

When a person is diagnosed with hemicrania continua, they might consider keeping a headache journal. This can assist them in determining whether or not their treatment plan is effective.

If a person experiences side effects from a medicine, they should talk to their doctor about possible alternate treatment alternatives.

Outlook

Hemicrania continua has no treatment, although it can be prevented by taking preventative medications on a regular basis.

The use of indomethacin may cause negative effects in some people. If a person experiences side effects, they should speak with their doctor about alternate treatment options that may be more successful in preventing headache discomfort.

Conclusion

Hemicrania continua is a chronic headache that affects one side of the head and can induce severe headaches on occasion.

Indomethacin, a type of NSAID, is the most effective medication.

To avoid pain, a person must take a regular dose of the drug for the rest of their lives.

If a person is unable to endure the main course of treatment, they should speak with their doctor about other medications that can help prevent the pain from recurring.

Sources

  • https://ichd-3.org/3-trigeminal-autonomic-cephalalgias/3-4-hemicrania-continua/
  • https://americanmigrainefoundation.org/resource-library/what-is-hemicrania-continua/
  • https://rarediseases.info.nih.gov/diseases/10795/hemicrania-continua
  • https://www.medicalnewstoday.com/articles/hemicrania-continua
  • https://migrainetrust.org/understand-migraine/types-of-migraine/other-headache-disorders/hemicrania-continua/
  • https://www.ninds.nih.gov/Disorders/All-Disorders/Hemicrania-Continua-Information-Page

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