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Chronic and Hemicrania Continua Headaches

By: Ian Murnaghan BSc (hons), MSc - Updated: 4 Apr 2016 | comments*Discuss
Hemicrania Continua Chronic Headaches

Chronic headaches are those occurring on a daily basis and affect about five percent of adults. They may be primary, where they gradually increase in frequency until they are occurring on a daily or near daily basis.

Alternately, they may be caused by an underlying disease or condition and thus classified as secondary. The consistent and repetitive nature of chronic headaches makes them particularly debilitating. They also account for the majority of referrals to headache specialists. By definition, a chronic headache occurs more than 15 days within a month.

What Are The Symptoms?

Hemicrania continua is a rare type of chronic daily headache where the pain occurs on one side of the head. Although the pain will vary in intensity, it never completely disappears and tends to be mild to moderate with occasional periods of intense pain. As with migraine headaches, there are more females than males with hemicrania continua.

Hemicrania continua exists in two forms known as continuous and remitting. In the continuous form, headaches occur daily with little or no respite, often for years. In the remitting form, headaches may occur regularly over 1 to 6 months, separated by pain free periods of several weeks to months. Pain may occur as short jabbing jolts alongside the persistent daily headache.

Some of the symptoms include those similar to migraines, such as:

  • Throbbing pain
  • Nausea or vomiting
  • Sensitivity to light
  • Sensitivity to sound

Symptoms may also mimic those of cluster headaches and include:

  • Tearing eyes and runny nose
  • Drooping eyelid
  • Redness on affected side
  • Brief bouts of intense pain on one side

What Are the Causes and Risk Factors?

There is typically no family history of headache in a patient with hemicrania continua. The precise causes and risk factors of hemicrania continua headaches are unknown but the following have been linked:

  • Medication overuse
  • Anxiety
  • Depression
  • Sleep Disorders
  • Obesity
  • Stimulants such as caffeine

Treatment Options

A non-steroidal anti-inflammatory drug (NSAID) called indomethacin is commonly taken to provide rapid relief from symptoms. Unlike migraines, hemicrania continua headaches are usually quite responsive to indomethacin. In fact, hemicrania continua is particularly sensitive to indomethacin. Often, the diagnosis may not be clear until indomethacin is tried due to hemocrania continua's shared features of both migraine and cluster headache.

Indomethacin is generally well tolerated although gastrointestinal side effects might indicate a need for acid-suppression therapy. It should also be noted that there is a risk of kidney damage with indomethacin and this is something that you should discuss with your doctor. Other NSAIDs such as ibuprofen, celecoxib, and naproxen may be helpful. Amitriptyline and other tricyclic antidepressants are also effective in some patients and your doctor will likely discuss all medication options. It is also important to identify stressors in day-to-day life as reducing these may help in managing this form of chronic headaches.

Hemicrania continua is a relatively well-treated form of chronic headaches and most sufferers can find complete to near-complete relief by avoiding triggers and using medication daily.

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Hi, have you tried seeing a Chiropractor? They don't treat any conditions but I have seen a lot of changes in my mum ever since she started seeing a chiropractor. She suffered chronic migraine for more than 20years.
Kerry - 4-Apr-16 @ 6:34 PM
@Purple chick - I'm afraid we can't issue medical advice, but if it affecting your work then you need to follow it up with your GP as you are doing currently. I hope you manage to find a cure.
HeadacheExpert - 10-Feb-15 @ 2:02 PM
Hi, I have been suffering from a chronic migrane for five weeks now.It was terribly painful for the first week and then eased off a bit, I took painkillers for the first two weeks and then tried to use them as sparingly as possible.I have seen three doctors now and have been prsecribed two different stronger medications.The migrane got really back again four days again and I took the medicine that the doctor had told me to if it got bad again, this masked the pain for about twelve hours.The next day it was bad again so I took a beta blocker, this had awful side effects, it lowered my blood pressure (which is normally low) and gave me insomnia and then awful nightmares when I got to sleep.I am trying to get a doctor appointment to discuss the next steps.They have said that they cannot refer me to a neurologist yet until they have followed all the required steps, which I think means trying lots of different medications.I work with children and do not feel that I can be on any kind of beta blocker long term (as the doctor suggested) because of the side effects. Any helpful advice would be very much appreciated.I am 31 years old, female and this is my first ever migrane.I am fit and healthy. Many thanks in advance!
Purple chick - 9-Feb-15 @ 11:36 PM
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