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Paroxysmal hemicranium
Last reviewed: 23.04.2024
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Paroxysmal hemicrania is manifested by attacks with pain characteristics and concomitant symptoms similar to those with headache. Distinguishing symptoms are short-term attacks and their high frequency. Paroxysmal hemicranium is more often observed in women, usually the disease begins in adulthood, but cases in children are also described. A specific feature of this form of cephalalgia is the effectiveness of indomethacin. Diagnostic criteria are presented below.
Paroxysmal hemicranium (MKGB-4)
- A. At least 20 seizures that meet BD criteria.
- B. Attacks of intense unilateral pain of orbital, supraorbital or temporal localization lasting 2-30 minutes.
- C. Headache is accompanied by at least one of the following symptoms:
- ipsilateral injections of conjunctiva and / or lacrimation;
- ipsilateral neuralgia and / or rhinorrhea:
- ipsilateral swelling of the eyelids;
- ipsilateral sweating of the forehead and face;
- ipsilateral miosis and / or ptosis.
- D. The prevalence of seizures is more than five times a day, sometimes somewhat less frequently.
- E. The seizures are completely prevented by the ingestion of indomethacin in a therapeutic dose.
- F. Not related to other causes (violations).
As well as with bundle hungry pain, there is an episodic (with remissions of 1 month or more) and a chronic form of paroxysmal hemicrania, in which the seizures are repeated for more than 1 year without remissions or with remissions of less than 1 month. There are cases of paroxysmal hemicrania, combined with trigeminal neuralgia (the so-called paroxysmal hemicrania-tick syndrome).
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Treatment of paroxysmal hemicrania
Specific therapy paroxysmal hemicrania - the use of indomethacin (inside or rectally at a dose of at least 150 mg / day or at least 100 mg in the form of injection). For maintenance therapy, smaller doses are also often effective.
More information of the treatment
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