Chronic paroxysmal hemicrania

NEET PG
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Chronic paroxysmal hemicrania

Chronic paroxysmal hemicrania (CPH) is a type of primary headache disorder that falls within the category of trigeminal autonomic cephalalgias (TACs). It shares similarities with cluster headaches and paroxysmal hemicrania but has distinct features. Here are key characteristics of chronic paroxysmal hemicrania:

  1. Frequency and Duration:
  • CPH is characterized by frequent, short-lasting headache attacks. The term “chronic” indicates that attacks occur on a daily basis.
  • Each attack typically lasts 2 to 30 minutes, making the headaches relatively brief.
  1. Timing:
  • Attacks can occur at any time of day and are not limited to specific circadian patterns.
  1. Location of Pain:
  • Similar to other trigeminal autonomic cephalalgias, the pain is usually unilateral (on one side of the head) and focused around the eye, temple, or forehead.
  1. Autonomic Symptoms:
  • CPH is associated with autonomic symptoms on the side of the headache, such as tearing of the eye, nasal congestion, and drooping of the eyelid.
  1. Response to Medication:
  • A distinguishing feature of CPH is its excellent response to treatment with indomethacin, a non-steroidal anti-inflammatory drug (NSAID). A positive response to indomethacin is often considered a key diagnostic criterion.
  1. Triggers:
  • Triggers for CPH attacks may not be as clearly defined as in some other headache disorders, but certain factors or behaviors may be associated with the onset of attacks.

It’s important to note that the diagnosis of chronic paroxysmal hemicrania requires a thorough evaluation by a healthcare professional, typically a neurologist or headache specialist. Other potential causes of headaches must be ruled out through clinical assessment and, in some cases, imaging studies.

Management of CPH often involves the use of indomethacin as the primary treatment. However, due to potential side effects and long-term considerations, healthcare providers may explore other treatment options or consider preventive medications in some cases.

If you suspect you have chronic paroxysmal hemicrania or are experiencing severe headaches, it’s essential to seek medical attention for proper diagnosis and appropriate management. A healthcare professional can provide an accurate diagnosis based on a comprehensive evaluation of your symptoms and medical history.