Bilateral Paroxysmal Hemicrania or Bilateral Paroxysmal Cephalalgia, Another Novel Indomethacin-Responsive Primary Headache Syndrome?

Episodic paroxysmal hemicrania with an atypical clinical presentation: a case report and review of the literature

“…In addition, there are rare case reports of patients with otherwise typical PH, including a good indomethacin response, who exhibit no autonomic features (1,8). Our case includes two Yes 150 *R, number of reference atypical features: bilateral localization and bilateral autonomic symptoms (see Table 1).…”

“…However, the literature contains five cases of PH that indicate bilateral headaches responding to indomethacin (1,(3)(4)(5), and only one of these cases included cranial autonomic features (4).…”

“…Matharu and Goadsby considered these presentation differences, including bilateral localization of headaches and lack of autonomic symptoms, to be cardinal and hypothesized that these headaches may represent a novel syndrome. They proposed that these cases should be classified separately from PH and proposed the term "bilateral paroxysmal cephalalgia" to describe this novel phenotype (1).…”

“…Paroxysmal hemicrania (PH) is a rare form of primary headache that usually begins in adulthood (1). Along with other trigeminal autonomic cephalalgias (TACs), it is classified in Group 3 in the Third Edition of The International Classification of Headache Disorders (ICHD-III) (2).…”

Trigeminal autonomic cephalgias

“…Боль может возникать в области верхней челюсти, вокруг уха и в редких случаях в области затылка. Иногда головная боль может быть двусторонней [48]. Боль распространяет-ся в область плеча, шеи или руки.…”