“Hemicrania Continua”: Another Headache Absolutely Responsive to Indomethacin

Cephalalgia ◽  
1984 ◽  
Vol 4 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Ottar Sjaastad ◽  
Egilius LH Spierings
Keyword(s):  
Temporal Pattern ◽  
Cervicogenic Headache ◽  
Hemicrania Continua ◽  
Paroxysmal Hemicrania ◽  
Dependent Effect ◽  
Unilateral Headache ◽  
Chronic Paroxysmal Hemicrania ◽  
Accompanying Symptoms ◽  
Dose Dependent ◽  
Dose Dependent Effect

Two cases suffering from a headache apparently at variance with well recognized headaches are described. It is characterized by a steady, non-paroxysmal, probably severe to moderately severe hemicrania localized anteriorly or anteroposteriorly and is not associated with nausea. Indomethacin exerts an absolute, persistent and clearly dose-dependent effect on this headache, which differs from unilateral headache syndromes such as cluster headache and cervicogenic headache in its temporal pattern and indomethacin response. It differs from chronic paroxysmal hemicrania in its temporal pattern and in the lack of accompanying symptoms.

The Hemicrania Continua Diagnosis

Cephalalgia ◽  
2001 ◽  
Vol 21 (10) ◽  
pp. 940-946 ◽  
Author(s):  
JA Pareja ◽  
F Antonaci ◽  
M Vincent
Keyword(s):  
Temporal Pattern ◽  
Hemicrania Continua ◽  
Paroxysmal Hemicrania ◽  
Remarkable Feature ◽  
Relative Paucity ◽  
Chronic Paroxysmal Hemicrania ◽  
Daily Headache ◽  
Group 3 ◽  
Clinical Pictures

More than 16 years after the first description of hemicrania continua (HC), its aetiology and pathogenesis remain obscure. Clinically, HC is considered a syndrome with two pivotal characteristics: (i) strictly unilateral (moderate, fluctuating, relatively long-lasting) headache; and (ii) absolute response to indomethacin. HC is further characterized by some ancillary, but mostly ‘negative’, features such as: (iii) relative paucity of accompaniments; and (iv) lack of precipitating factors. The female preponderance is also remarkable, although not diagnostic in the solitary case. Finally, a non-specific, but remarkable feature is the temporal pattern. HC may present as a remitting or chronic (continuous) headache. In HC, unilaterality and absolute response to indomethacin are considered crucial diagnostically. Existing controversy, such as regarding atypical features, particularly the so-called ‘HC resistant to indomethacin’, is discussed. The nature of hemicrania with negative indomethacin response remains most unclear; it may not belong to the HC cycle at all. Accordingly, we propose that the typical clinical picture of HC, including an absolute response to indomethacin, be termed Hemicrania continua vera. More or less analogous, but indomethacin-resistant, clinical pictures can provisionally be termed Hemicrania generis incerti (of undetermined nature), provided other diagnostic possibilities have been ruled out. The differential diagnosis of HC vs. other unilateral headaches is commented on. Previous attempts at classification of HC into the group chronic daily headache (CDH) are discussed. The only acceptable ‘link’ of HC with the other headaches classified as CDH is the temporal pattern (which is a non-specific feature). HC is probably pathophysiologically different from the others disorders classified under CDH. Conversely, HC and chronic paroxysmal hemicrania share many common features, including the absolute response to indomethacin. HC should probably be included in the IHS group 3.

“Hemicrania Continua”. An Indomethacin Responsive Headache. II. Autonomic Function Studies

Cephalalgia ◽  
1984 ◽  
Vol 4 (4) ◽  
pp. 265-273 ◽  
Author(s):  
O Sjaastad ◽  
ELH Spierings ◽  
C Saunte ◽  
Maria M Wysocka Bakowska ◽  
I Sulg ◽  
...  
Keyword(s):  
Autonomic Function ◽  
Hemicrania Continua ◽  
Paroxysmal Hemicrania ◽  
Unilateral Headache ◽  
Different Types ◽  
Chronic Paroxysmal Hemicrania ◽  
Symptomatic Side

Various autonomic parameters have been studied in two patients with “hemicrania continua”, a newly described unilateral headache which is aborted by indomethacin. Striking findings were made on pupillometry: In both patients, isocoria was present when untreated. Bilateral instillation of tyramine in the conjunctival sac resulted in a late appearing anisocoria, with the smaller pupil on the symptomatic side. Indomethacin medication corrected this anomaly. These findings add further evidence to our firm belief that “hemicrania continua” differs fundamentally from chronic paroxysmal hemicrania, where such pupillometric changes are not found. There thus seem to be at least two different types of hemicranias with an absolute indomethacin effect.

scholarly journals Silver‐doped sol‐gel borate glasses: Dose‐dependent effect on Pseudomonas aeruginosa biofilms and keratinocyte function

2021 ◽  
Author(s):  
Shiva Naseri ◽  
Gabriele Griffanti ◽  
William C. Lepry ◽  
Vimal B. Maisuria ◽  
Nathalie Tufenkji ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Sol Gel ◽  
Borate Glasses ◽  
Dependent Effect ◽  
Dose Dependent ◽  
Dose Dependent Effect

Dose, Efficacy and Tolerability of Long-Term Indomethacin Treatment of Chronic Paroxysmal Hemicrania and Hemicrania Continua

Cephalalgia ◽  
2001 ◽  
Vol 21 (9) ◽  
pp. 906-910 ◽  
Author(s):  
JA Pareja ◽  
AB Caminero ◽  
E Franco ◽  
JL Casado ◽  
J Pascual ◽  
...  
Keyword(s):  
Hemicrania Continua ◽  
Paroxysmal Hemicrania ◽  
Chronic Paroxysmal Hemicrania ◽  
Indomethacin Treatment

Dose-Dependent Effect of Statins on the Incidence of Acute Kidney Injury After Cardiac Surgery

2011 ◽  
Vol 91 (2) ◽  
pp. 520-525 ◽  
Author(s):  
Salima Mithani ◽  
Michael Kuskowski ◽  
Yelena Slinin ◽  
Areef Ishani ◽  
Edward McFalls ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Kidney Injury ◽  
Dependent Effect ◽  
Dose Dependent ◽  
Dose Dependent Effect

Ligand-Regulated Expression of TNF Receptors 1 and 2 Determines Receptor-Mediated Functional Responses

2021 ◽  
pp. 1-12
Author(s):  
Alina Alshevskaya ◽  
Olga Koneva ◽  
Irina Belomestnova ◽  
Julia Lopatnikova ◽  
Irina Evsegneeva ◽  
...  
Keyword(s):  
Biological Effects ◽  
High Expression ◽  
Functional Responses ◽  
Double Positive ◽  
Dependent Effect ◽  
Similar Expression Profile ◽  
Proliferation Response ◽  
Dose Dependent ◽  
Dose Dependent Effect ◽  
Mcf 7

<b><i>Introduction:</i></b> Modulating specific biological effects through the changes in cytokine receptors’ expression level remains poorly understood. This study aimed to investigate the influence of the dose-dependent effect of TNF on the balance between proapoptotic and proliferation response depending on the parameters of TNFR1/2 expression density. <b><i>Methods:</i></b> Tumor cell lines (HEp-2, K-562, MCF-7, ZR-75/1, MOLT-4, IM-9, and Raji) were characterized for TNFR1/2 co-expression using flow cytometry and were studied to reveal the dose-dependent effect of rhTNF on cell cycle and apoptosis parameters. The associations among the studied parameters were estimated by correlation and regression analysis. <b><i>Results:</i></b> It was found for ZR-75/1 cells (the cell line characterized by high expression of both types) that a dose-dependent increase in expression of both types of TNF-α receptors on cells reduces the proliferative activity of cells. For MOLT-4 cells (which are characterized by lower expression), an increase in proliferative response of cells was positively associated with the percentage of both TNFR1<sup>+</sup> and TNFR2<sup>+</sup> cells. However, opposite effects on the cells were shown for the K-562 and MCF-7 lines having a similar expression profile. A similarity (a large percentage of double-positive cells) was revealed for the lines having similar effects (K-562 and ZR-75/1). <b><i>Conclusions:</i></b> High expression of TNF receptor type 1 is not always associated with predominant activation of proapoptotic pathways. However, in the case of simultaneous high expression of both types of receptors, the proportion of double-positive cells is crucial for the activation of either the proapoptotic or proliferation pathways.

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