PAROXYSMAL HEMICRANIA

Symptoms & Diagnosis

It involves short lasting attacks (2 – 45mins) of severe pain associated with several features including eye-watering, eye redness and nasal running. They can occur multiple times a day, 2-40 times. Unlike cluster headache, PH does not have a particular pattern and is more common in women. They can be episodic and chronic. Episodic PH occur at least twice a year and attacks last anywhere from seven days to a year with pain-free periods of 3 months or longer separating them. Chronic PH occur over the course of more than a year without remission or with remissions lasting less than 3 months.

PH can be confused with cluster headache, especially when people with PH have constant background pain between attacks. There is considerable overlap in the signs and symptoms of PH and cluster headache. The only way to tell the difference between PH and cluster headache is that PH responds well to treatment with a medicine called indomethacin, an NSAID (non-steroidal anti-inflammatory drug). A trial is carried out whilst keeping a strict headache diary whilst it is increased. A stomach-protective agent should be added in order to reduce the possible gastric problems, especially if patients require long term treatment.