Paroxysmal hemicrania: a retrospective study of a consecutive series of 22 patients and a critical analysis of the diagnostic criteria

Prakash, Sanjay; Belani, Pooja; Susvirkar, Ashish; Trivedi, Aditi; Ahuja, Sunil K.; Patel, Animesh

doi:10.1186/1129-2377-14-26

Cited by 19 publications

(36 citation statements)

References 20 publications

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“…PH is typically characterized by repeated attacks of severe, strictly unilateral pain lasting 2–30 min, localized to orbital, supraorbital, and temporal areas accompanied by ipsilateral autonomic features of conjunctival, nasal, facial and eyelid symptoms or signs. But some atypical PH patients do not have accompaniment of autonomic symptoms and the pain duration may extend to hours (Boes and Dodick 2002 ; Maggioni 2010 ; Prakash et al 2013 ). This atypical episodic or chronic PH may have some LH-like features, but the LH pain striding the trigeminal and occopital nerve innervating areas is obviously different from the PH pain localized to orbital, supraorbital, and temporal areas or in any combination of these sites.…”

Section: Discussionmentioning

confidence: 99%

Linear headache: clinical characteristics of eight new cases

Pan

et al. 2016

SpringerPlus

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BackgroundLinear headache (LH) has recently been described as a paroxysmal or continuous fixed head pain restricted in a linear trajectory of 5–10 mm in width, linking one endpoint in occipital or occipitocervical region with another endpoint in ipsilateral nasion or forehead region. For some patients, this headache had some features resembling migraine without aura.MethodsWe made a prospective search of patients presenting with a clinical picture comprised under the heading of LH and we have accessed eight new cases. A detailed clinical feature of the headache was obtained in all cases to differentiate with cranial neuralgia, paroxysmal hemicrania, cervicogenic headache, nummular headache and migraine.ResultsThe eight LH patients complained of a recurrent moderate to severe, distending, pulsating, or pressure-like pain within a strictly unilateral line-shaped area. The headache duration would be ranged from 1 h to 2 days or persistent for 1–6 months with recurrent worsening of headaches. For some patients, this headache had couple of features similar to that of migraine pattern, such as accompaniments of nausea, vomiting, and phonophobia, diziness, triggering factors of noise, bright night, resting after physical activity, fatigue, menstruation, and response to anti-migraine therapy.ConclusionsThis description reinforces the proposal of LH as a new headache syndrome or a new variant of a previously known headache syndrome, probably of migraine.

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Section: Discussionmentioning

confidence: 99%

Linear headache: clinical characteristics of eight new cases

Pan

et al. 2016

SpringerPlus

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“…[ 6 ] A more recent prospective study of 31 patients found a female to male ratio of 1:1[ 7 ] similar to a smaller retrospective cohort of 22 patients. [ 8 ] This is in contrast to cluster headache which is about three times as common in men. [ 9 10 ]…”

Section: S Ex D Istributionmentioning

confidence: 99%

Paroxysmal hemicrania

Bahra¹,

Osman²

2018

Ann Indian Acad Neurol

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Paroxysmal hemicrania (PH) is a primary headache disorder belonging to the group of trigeminal autonomic cephalalgias(TACs). Patients typically experience intense lateralzsed headaches with pain primarily in the ophthalmic trigeminal distribution (V1) associated with superimposed ipsilateral cranial autonomic features. PH is distinguished from other TACs by an exquisite responsiveness to therapeutic doses of indomethacin. Patients may need to be maintained on indomethacin for several months before trials of reduction can be attempted. The disorder does have a tendency toward chronicity. PH is uncommon, but early recognition will prompt initiation of effective treatment to avoid unsuccessful trials of drugs effective in other primary headaches. As with other TACs, hypothalamic and trigeminovascular mechanisms are implicated in the pathophysiologic mechanism of PH. Neuroimaging findings in PH demonstrate a posterior hypothalamic activation similar to that observed in the other TACs. This review will address the epidemiology, clinical presentation, pathophysiology, evaluation, and treatment of PH.

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“…The median dose was 175 mg/day . In Prakash et al's series of PH patients, the mean effective daily dose of IMC was 149 mg (range 50–225) …”

Section: Imc Pharmacologymentioning

confidence: 99%

“…In the Prakash et al paper, 23 patients showed complete response to IMC within 24 hours. It took more than one week for 12% of the patients to achieve remission . In the Pareja et al series, the patients took “approximately 3 days” to respond to their IMC treatment …”

Section: Imc Pharmacologymentioning

confidence: 99%

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Indomethacin Responsive Headaches: Exhaustive Systematic Review With Pooled Analysis and Critical Appraisal of 81 Published Clinical Studies

Bordini

Bordini²,

Woldeamanuel

et al. 2016

Headache

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The "velocity" of publications on IMC and headache seems to be decreasing, particularly on the use of IMC for the treatment of TACs. The science behind the understanding of the putative mechanisms of IMC's action on headache has moved forward, but the answer to why it works better than other nonsteroidal anti-inflammatory drugs has been elusive. There are case reports of other rare headache disorders that may be responsive to IMC. The dosages of IMC used as a tool for detecting IMC responsive disorders vary according to different centers of investigation. In many circumstances, headache disorders similar to "primary" IMC-responsive disorders are actually symptomatic disorders. Cluster headache as an IMC-resistant headache disorder may not be as absolute as once thought. Sometimes, IMC has been found to provoke headache; differentiating IMC-provoked headache from IMC-resistant headache can make headache diagnosis and management difficult. As for the "absolute" responsiveness of IMC, it is possible that using higher dosages leads to higher sensitivity, probably at the expense of decreased specificity. There are many reports about the occurrence of two or more IMC-responsive disorders (latu sensu) in the same patient, which may be coincidental.

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Paroxysmal hemicrania: a retrospective study of a consecutive series of 22 patients and a critical analysis of the diagnostic criteria

Cited by 19 publications

References 20 publications

Linear headache: clinical characteristics of eight new cases

Linear headache: clinical characteristics of eight new cases

Paroxysmal hemicrania

Indomethacin Responsive Headaches: Exhaustive Systematic Review With Pooled Analysis and Critical Appraisal of 81 Published Clinical Studies

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