Chronic paroxysmal hemicrania

Chronic paroxysmal hemicrania (CPH) is a neurological disorder characterized by severe, unilateral headache attacks. The condition is a type of trigeminal autonomic cephalalgia (TAC), a group of primary headache disorders that also includes cluster headache and SUNCT syndrome.

Symptoms

The primary symptom of chronic paroxysmal hemicrania is severe, unilateral headache. These headaches are typically located around the eye or temple, and can be accompanied by other symptoms such as tearing, nasal congestion, and eyelid drooping. The pain is often described as sharp, stabbing, or throbbing, and can last from 2 minutes to 30 minutes. Attacks can occur up to 40 times a day, and are more common during the day than at night.

Causes

The exact cause of chronic paroxysmal hemicrania is unknown. However, it is thought to involve the hypothalamus, a part of the brain that regulates many bodily functions, including pain perception. Some researchers believe that CPH may be related to abnormalities in the trigeminal nerve, which is responsible for sensation in the face.

Diagnosis

Diagnosis of chronic paroxysmal hemicrania is based on the patient's symptoms and the exclusion of other conditions. The International Headache Society has established criteria for the diagnosis of CPH, which include the presence of at least 20 attacks of unilateral headache, lasting 2-30 minutes, and occurring more than five times a day for more than half of the time.

Treatment

Treatment for chronic paroxysmal hemicrania primarily involves medication. The drug of choice is indomethacin, a type of nonsteroidal anti-inflammatory drug (NSAID). Other treatments may include corticosteroids, calcium channel blockers, and anticonvulsants.

See also

• Cluster headache
• SUNCT syndrome
• Trigeminal autonomic cephalalgias