Journal of the Neurological Sciences
Volume 277, Issue 1 , Pages 187-190, 15 February 2009

Is there need to search for alternatives to indomethacin for hemicrania continua? Case reports and a review☆☆☆

  • Sanjay Prakash

      Affiliations

    • Department of Neurology, Medical College, SSG Hospital, Baroda, Gujarat 390001, India
    • Corresponding Author InformationCorresponding author. O-19, Doctor's Quarter, Jail Road, Baroda, Gujarat 390001, India. Tel.: +919898129484; fax: +91 02692 258700.
    • ,
  • Mahammed Husain

      Affiliations

    • Department of Medicine, Medical College, SSG Hospital, Baroda, Gujarat 390001, India
    • ,
  • Dhara S Sureka

      Affiliations

    • Department of Neurology, Medical College, SSG Hospital, Baroda, Gujarat 390001, India
    • ,
  • Nimish P Shah

      Affiliations

    • Department of Neurology, Medical College, SSG Hospital, Baroda, Gujarat 390001, India
    • ,
  • Nilima D Shah

      Affiliations

    • Medical College, SSG Hospital, Baroda, Gujarat, India

Received 11 August 2008; received in revised form 23 October 2008; accepted 31 October 2008.

Abstract 

Hemicrania continua (HC) is a daily continuous unilateral headache of moderate intensity with super imposed exacerbations of more severe pain accompanied by migrainous and cranial autonomic features. Response to indomethacin is an essential feature in the IHS diagnostic criteria. However, indomethacin is associated with a number of side effects. HC is a life long condition, and skipping of a single dose of indomethacin usually leads to reappearance of headache. Various drugs have been tried as alternatives to indomethacin in the patients intolerant to indomethacin. We report two cases of HC responsive to topiramate and review the available alternatives for the patients of HC. We also discuss the side effects of indomethacin in the various headache disorders and other painful conditions, and suggest the need for trial of other drugs for the patients of HC.

Keywords: Hemicrania continua, Idomethacin responsive headaches, Indomethacin and side effects

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☆ This manuscript was not presented at any meeting or published, nor is being considered for publication elsewhere.

☆☆ Written informed consent was taken from the patients to publish the report.

PII: S0022-510X(08)00562-5

doi:10.1016/j.jns.2008.10.027

Journal of the Neurological Sciences
Volume 277, Issue 1 , Pages 187-190, 15 February 2009

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