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2018 ; 21
(Suppl 1
): S16-S22
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Paroxysmal Hemicrania
#MMPMID29720814
Osman C
; Bahra A
Ann Indian Acad Neurol
2018[Apr]; 21
(Suppl 1
): S16-S22
PMID29720814
show ga
Paroxysmal hemicrania (PH) is a primary headache disorder belonging to the group
of trigeminal autonomic cephalalgias(TACs). Patients typically experience intense
lateralzsed headaches with pain primarily in the ophthalmic trigeminal
distribution (V1) associated with superimposed ipsilateral cranial autonomic
features. PH is distinguished from other TACs by an exquisite responsiveness to
therapeutic doses of indomethacin. Patients may need to be maintained on
indomethacin for several months before trials of reduction can be attempted. The
disorder does have a tendency toward chronicity. PH is uncommon, but early
recognition will prompt initiation of effective treatment to avoid unsuccessful
trials of drugs effective in other primary headaches. As with other TACs,
hypothalamic and trigeminovascular mechanisms are implicated in the
pathophysiologic mechanism of PH. Neuroimaging findings in PH demonstrate a
posterior hypothalamic activation similar to that observed in the other TACs.
This review will address the epidemiology, clinical presentation,
pathophysiology, evaluation, and treatment of PH.