Is there need to search for alternatives to indomethacin for hemicrania continua? Case reports and a review

Abstract Hemicrania continua (HC) is a daily continuous unilateral headache of moderate intensity with super imposed exacerbations of more severe pain accompanied by migrainous and cranial autonomic features. Response to indomethacin is an essential feature in the IHS diagnostic criteria. However, i...

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Bibliographic Details
Published in:Journal of the neurological sciences 2009-02, Vol.277 (1), p.187-190
Main Authors: Prakash, Sanjay, Husain, Mahammed, Sureka, Dhara S, Shah, Nimish P, Shah, Nilima D
Format: Article
Language:English
Subjects:
Adult
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Anticonvulsants - therapeutic use
Autonomic nervous system
Biological and medical sciences
Fructose - analogs & derivatives
Fructose - therapeutic use
Headache Disorders - drug therapy
Hemicrania continua
Humans
Idomethacin responsive headaches
Indomethacin - therapeutic use
Indomethacin and side effects
Male
Medical sciences
Middle Aged
Neurology
Tumors of the nervous system. Phacomatoses
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Summary:Abstract Hemicrania continua (HC) is a daily continuous unilateral headache of moderate intensity with super imposed exacerbations of more severe pain accompanied by migrainous and cranial autonomic features. Response to indomethacin is an essential feature in the IHS diagnostic criteria. However, indomethacin is associated with a number of side effects. HC is a life long condition, and skipping of a single dose of indomethacin usually leads to reappearance of headache. Various drugs have been tried as alternatives to indomethacin in the patients intolerant to indomethacin. We report two cases of HC responsive to topiramate and review the available alternatives for the patients of HC. We also discuss the side effects of indomethacin in the various headache disorders and other painful conditions, and suggest the need for trial of other drugs for the patients of HC.
ISSN:0022-510X
1878-5883
DOI:10.1016/j.jns.2008.10.027