Hemicrania Continua Headaches: Chronic Headache Conditions

Learn what to look for in chronic back-to-back migraine headaches

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A hemicrania continua headache is a sub-type of chronic headache experienced by migraine sufferers. Most patients with hemicrania continua headaches report pain more than 5 times in a 24-hour period and at least 15 times a month. By definition, hemicrania continua occurs on just one side of the head. The chronic pain is generally continuous and fluctuates in intensity with few breaks in between. The pain you experience is exacerbated by sharp, jabbing pain on the same side.

You may even experience pain that moves between each side of the head during one headache episode which researchers have found may occur.

The Case of Sharon and Hemicrania Continua

A woman named Sharon described her headache pain like this, "All I could do was lie in the dark and pray that God would take the pain away." In Sharon's case, the pain associated with hemicrania continua headaches started on one side of her head, eventually moving into her neck, shoulders, back and then her face. She told physicians that at times the pain was so severe it caused her to pass out. Sharon's experience is similar to those of many people with hemicrania continua headaches.

Symptoms, Prevalence and Diagnosis of Hemicrania Continua

In addition to chronic pain, symptoms of the disorder include runny nose, tearing and redness of the eyes, sweating, drooping eyelids, nausea, vomiting and sensitivity to light.

It is unknown how prevalent hemicrania continua headaches are among the public. Chronic headaches, the larger classification, affect 4 to 5% of the general population. Other chronic headache sub-types include transformed migraine, chronic tension-type headache and new daily persistent headache. Among those who suffer from chronic headaches, a 5-year study of 651 headache sufferers found that 2.2% of these study participants experienced hemicrania continua headache pain.

Researchers have found that hemicrania continua headaches, like migraine headaches, are more common among women. In addition, research indicates that exercise and alcohol consumption can worsen hemicrania continua headache symptoms.

Treating Hemicrania Continua

Because no cause of hemicrania continua is known, drugs are used to treat the symptoms. One commonly prescribed treatment for hemicrania continua is indomethacin, an anti-inflammatory oral medication. Hemicrania continua headaches are referred to as indomethacin responsive, meaning in most cases the symptoms are eliminated after several doses of the drug. However, as with other anti-inflammatory medications, the side effects of indomethacin often preclude long-term usage. In fact, 25% to 50% of patients on indomethacin therapy eventually develop the gastrointestinal side effects commonly caused by this medication, including abdominal pain, stomach ulcers and intestinal bleeding. Other side effects may include excessive fatigue, unexplained bruising or bleeding, blurred vision, ringing in the ears and chronic constipation.

Other Treatment Options

Although no medication has been proven to treat hemicrania continua headaches as effectively as indomethacin, new research has uncovered other treatment options. Several case studies have demonstrated that the herbal supplement melatonin could be a promising alternative therapy. Available over-the-counter melatonin has a chemical structure similar to indomethacin, but it is found naturally in the body. One case study indicated a 7-mg supplement at bedtime completely relieved symptoms for this individual. However, the herbal supplement is not subject to approval by the FDA and -- as with any medical condition -- patients should consult their healthcare provider before beginning any therapy.  According to the National Institutes of Health, side effects may include dizziness, mood changes, increased risk of seizure, decreased sperm count among men, decrease in blood pressure and increased blood sugar levels.

Researchers have also found the prescription drug topiramate to be a promising treatment. Topiramate is an anti-convulsant medication that reduces irregular brain activity. Although several small case studies have found the medicine beneficial, larger studies are needed to learn whether the benefits of the drug outweigh the potential side effects, which include dizziness, inability to concentrate, confusion, increased risk of kidney stones and increased risk of osteoporosis. In addition, topiramate can cause difficulty for a person to sweat. As with any medication regiment, care should be taken to follow your doctor's orders. Missing doses can lead to a "rebound effect." This refers to a resurgence of headache symptoms as soon as the medication is out of the bloodstream. If the side effects of a medication become troublesome, patients should consult with their healthcare provider before stopping treatment.


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