What is Hemicrania Continua

Hemicrania Continua is a rare, primary headache disorder characterized by a continuous, strictly one-sided headache that fluctuates in intensity but never completely disappears. It is uniquely distinguished from other chronic headaches by its absolute responsiveness to the medication indomethacin, which often serves as both a diagnostic and therapeutic tool.

What are the primary symptoms of Hemicrania Continua?

Hemicrania Continua presents as a persistent, moderate-to-severe pain localized to one side of the head. During periods of exacerbation, patients typically experience autonomic symptoms on the affected side, such as tearing, nasal congestion, eyelid drooping, or redness of the eye. Because Hemicrania Continua is continuous, it can significantly impact quality of life, often leading to fatigue and social isolation among our 86 community members on DiseaseMaps.org.

What causes Hemicrania Continua?

The exact pathophysiology of Hemicrania Continua remains a subject of ongoing research. Current clinical consensus suggests it involves the activation of the trigeminal autonomic reflex and the posterior hypothalamus. Unlike migraines, which are often episodic, Hemicrania Continua is classified as a chronic disorder, meaning the pain is unremitting and present for more than three months.

Who is typically affected by Hemicrania Continua?

While exact prevalence data is limited due to frequent underdiagnosis, Hemicrania Continua is estimated to affect more women than men (a ratio of approximately 2:1). The average age of onset is typically in early to middle adulthood, though it can occur at any age. Key differentiating factors include:

• Indomethacin response: The hallmark diagnostic criterion is the complete resolution of symptoms with indomethacin.


• Constant nature: Unlike cluster headaches, which are brief and episodic, the pain in Hemicrania Continua is continuous.


• Autonomic features: These symptoms coincide strictly with the side of the head where the pain is felt.

Next steps

• Consult a board-certified neurologist or a headache specialist to discuss an indomethacin trial.


• Keep a detailed headache diary to track pain intensity and associated autonomic symptoms.


• Join the Hemicrania Continua support group on DiseaseMaps.org to connect with others sharing their experiences.

Medical disclaimer: This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment; always seek the advice of a qualified healthcare provider.

References

• NIH Genetic and Rare Diseases Information Center (GARD)


• Orphanet: Portal for rare diseases and orphan drugs


• International Headache Society (IHS) Classification of Headache Disorders


• American Migraine Foundation: Resources on Hemicrania Continua