Hemicrania continua

Hemicrania continua is a primary headache disorder characterized by a persistent and severe pain that is felt on one side of your head.

It differs from other types of headaches in that the pain is continuous without a break.

Hemicrania continua is considered a primary headache disorder, which means it's not caused by another underlying medical condition. The condition can be effectively managed with appropriate treatment, which may include medication and, in some cases, nerve blocks or surgery.

Causes of hemicrania continua

The exact cause of hemicrania continua remains unclear, but it's believed to be related to abnormalities in the nervous system or certain structures in the brain.

Unlike some other types of headaches, hemicrania continua is not typically associated with triggers like stress, certain foods or environmental factors. However, in some cases, there may be factors that can exacerbate the condition or contribute to the severity of symptoms. More research is needed to fully understand the underlying reasons you may get this persistent headache.

Symptoms of hemicrania continua

The most noticeable symptom of hemicrania continua is persistent, one-sided head pain that’s often severe but never completely goes away. This continuous pain distinguishes hemicrania continua from other types of headaches.

In addition to the constant head pain, individuals with hemicrania continua may experience other symptoms on the same side as the headache. These can include:

• Tearing of the eye
• Stuffy or runny nose
• Drooping eyelid

These symptoms can further contribute to discomfort from hemicrania continua and impact your daily activities. It's essential to consult your doctor if you have a persistent headache to get help managing your symptoms and pain.

What tests are done for hemicrania continua?

Diagnosing hemicrania continua typically involves a thorough medical evaluation by your doctor.

While there’s no specific test to confirm the presence of hemicrania continua, the diagnosis is based on the symptoms and findings by your doctor. Digital imaging tests such as an MRI or CT scans are not typically necessary to diagnose hemicrania continua. However, your doctor may order them in certain cases to rule out other potential causes of headaches.

During the evaluation, your doctor will ask about your symptoms, including the nature and duration of your headaches. They will also ask about any associated symptoms and any factors that may exacerbate or alleviate your symptoms, such as ongoing stress or any foods you have eaten recently.

Your doctor may perform a physical examination to check your neurological function, cranial nerves and other relevant parts of your health. Specific tests may also be ordered to evaluate for signs of hemicrania continua, such as a drooping eyelid.

How do you treat hemicrania continua?

Treating hemicrania continua is focused on reducing the frequency and severity of headaches and alleviating associated symptoms. While there is no cure for hemicrania continua, several treatment options are available to help you manage the condition and improve quality of life. Treatment strategies may include:

• Prescription anti-inflammatory drugs: Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that is considered the gold standard for treating hemicrania continua.
• Over-the-counter pain relievers: In cases where indomethacin is not well tolerated or ineffective, over-the-counter medications such as ibuprofen or naproxen may be recommended.
• Nerve blocks: Nerve blocks involve injecting a local anesthetic or corticosteroid near the affected nerves to interrupt pain signals and provide relief from headaches.
• Surgery: In rare cases where other treatments have failed, surgery may be considered as a last resort. Procedures such as occipital nerve stimulation or deep brain stimulation have been explored as potential treatment options for hemicrania continua, but these approaches are typically reserved for severe cases and require careful consideration and evaluation by an Advocate neuro specialist.

Regular follow-up appointments with your provider are important to help monitor your response to treatment, adjust medication dosages as needed and address any new or worsening symptoms.