Paroxysmal Hemicrania

Symptoms and Treatment for Paroxysmal Hemicrania

Paroxysmal hemicrania (PH) is a rare form of headache that resembles cluster headache in some respects. However, PH is more common in women and while it usually begins in adulthood, it has been reported in girls as young as 6 years old. This condition is characterized by multiple, short, one-sided and severe head pain attacks. There are two forms, chronic and episodic. Patients with chronic paroxysmal hemicrania experience daily attacks for a year or more; in patients with the episodic form, the headaches go into remission for months or years. If you believe that you might be suffering from paroxysmal hemicrania, schedule a visit to the Diamond Headache Clinic for a thorough evaluation, accurate diagnosis and effective treatment.

Man in pain because of paroxysmal hemicrania

What Are the Symptoms of Paroxysmal Hemicrania?

Signs and symptoms of this rare headache condition may include:

  • Unilateral (one-sided) pain concentrated around the eye, temple and forehead region
  • Severe throbbing, claw-like or boring pain
  • An average of 10 – 20 attacks per day
  • Each attack lasts from 2 – 30 minutes (average duration is 10 – 15 minutes)
  • Headache is accompanied by at least one of the following occurring on the same side as the head pain:
    • Eye redness and/or tearing
    • Nasal congestion and/or runny nose
    • Eyelid swelling
    • Forehead and facial sweating
    • Eyelid drooping and/or pupil constriction
  • Attacks are prevented completely by therapeutic doses of the NSAID Indomethacin

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How Is Paroxysmal Hemicrania Diagnosed?

At the Diamond Headache Clinic, a diagnosis is based on a combination of the patient’s medical history, physical exam and neurological testing. While the history and clinical symptoms may seem sufficient to diagnose paroxysmal hemicrania, we order brain-imaging tests to rule out structural abnormalities and other conditions with similar symptoms, such as tumors. When your doctor is fairly certain that you suffer from paroxysmal hemicrania, you will be prescribed a therapeutic dose of Indomethacin. This NSAID (non-steroidal anti-inflammatory drug) completely relieves the symptoms; a positive response to Indomethacin is confirmation of a PH diagnosis.

What Are the Paroxysmal Hemicrania Treatment Options?

While paroxysmal hemicrania causes have not been fully identified, treatment is available. The most effective treatment for paroxysmal hemicrania is the prescription NSAID, Indomethacin, which offers complete relief. Patients who cannot tolerate this drug may be prescribed less effective NSAIDs, calcium-channel blockers or corticosteroids. With medical treatment under the supervision of a headache specialist, most patients experience complete or significant relief of their symptoms. PH may last indefinitely, or it can go into remission or even stop spontaneously.

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