Document Detail


Treatment of hemicrania continua: case series and literature review.
MedLine Citation:
PMID:  22440373     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Hemicrania Continua (HC) is a primary, disabling headache characterized by a continuous unilateral pain and responsive to indomethacin. There are symptoms common to the trigeminal-autonomic cephalalgias and migraine that complicate the diagnosis. This review aims to describe HC in a case series and review the best available evidence on alternative therapies.
METHOD: A systematic review of medical records and diaries of pain of 1,600 patients treated between January 1992 and January 2011 in a headache outpatient clinic.
RESULTS: Ten patients with a possible diagnosis of hemicrania continua were selected; seven were diagnosed with HC according to the II International Classification of Headache Disorders. None of the patients had received the correct diagnosis before being treated at the outpatient clinic and the average time for treatment was 12 years. Prophylactic treatment was effective in 66.6% of cases with amitriptyline, 20% with gabapentin and 10% with topiramate.
CONCLUSIONS: HC should be considered among the diagnostic hypotheses of patients with continuous headache, with no change in neurological examination and additional tests, regardless the age of onset. The standard treatment with indomethacin (100-150mg.day(-1)) has significant risks associated with both short and long term use and may not be a good choice for continuous use. Recent studies point out possible alternatives: gabapentin, topiramate, cyclooxygenase-2 inhibitors, piroxicam, beta-cyclodextrin, amitriptyline, melatonin. Other drugs were described in different reports as efficient, but most of them were considered inefficient in other HC cases.
Authors:
Lídia Maria Veras Rocha de Moura; José Marcelo Ferreira Bezerra; Norma Regina Pereira Fleming
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Revista brasileira de anestesiologia     Volume:  62     ISSN:  1806-907X     ISO Abbreviation:  Rev Bras Anestesiol     Publication Date:    2012 Mar-Apr
Date Detail:
Created Date:  2012-03-23     Completed Date:  2012-09-25     Revised Date:  2014-02-05    
Medline Journal Info:
Nlm Unique ID:  0401316     Medline TA:  Rev Bras Anestesiol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  173-87     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Editora Ltda. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Female
Headache / drug therapy*
Humans
Indomethacin / therapeutic use*
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; XXE1CET956/Indomethacin

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