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Hemicrania continua

Ten new cases and a review of the literature

Departments of Neurology (Drs. Newman, Lipton, and Solomon) and Epidemiology and Social Medicine (Dr. Lipton), The Albert Einstein College of Medicine, and The Montefiore Headache Unit (Drs. Newman, Lipton, and Solomon), Montefiore Medical Center, Bronx, NY.

We describe 10 new patients and review the 24 prior reports of hemicrania continua, an uncommon, unilateral headache disorder. The disorder is characterized by a continuous baseline headache of moderate severity with superimposed exacerbations of more severe pain. These exacerbations are sometimes associated with ipsilateral autonomic disturbances. There are three temporal patterns: a chronic, nonremitting headache from onset; a remitting variety consisting of distinct phases of continuous unilateral headaches that persist for weeks to months followed by pain-free remissions; and an evolving form in which initially remitting headaches transform into the chronic, non-remitting pattern. Accurate diagnosis is important as all forms are characterized by a dramatic and selective response to indomethacin.

Address correspondence and reprint requests to Dr. Lawrence C. Newman, Department of Neurology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467.

Presented in part at the 45th annual meeting of the American Academy of Neurology, New York, NY, April 1993, and the meeting of the American Association for the Study of Headache, San Francisco, CA, June 1993.

Received February 24, 1994. Accepted in final form May 20, 1994.

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