A Combination of Indomethacin Farnesyl and Amitriptyline is Effective for Continuous Interictal Pain with Probable Chronic Paroxysmal Hemicrania

Two new chronic paroxysmal hemicrania patients are described. In both, attacks can be precipitated mechanically by applying firm manual pressure to certain sensitive points on the neck, i.e. in the C2 area, in the transverse processes of the C4–C5 vertebrae, or beneath the posterior part o15 the skull on the symptomatic side. The most sensitive area seems to be the transverse process of C4–C5. Susceptibility to this type of attack is dependent on the flow of spontaneous attacks; attacks are easily precipitated in a phase with multiple spontaneous attacks, but are not readily precipitated otherwise. Under indomethacin protection, local tenderness is clearly diminished and attacks cannot be precipitated.

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Chronic Paroxysmal Hemicrania: Salivation, Tearing and Nasal Secretion

Cephalalgia ◽

10.1046/j.1468-2982.1984.0401025.x ◽

1984 ◽

Vol 4 (1) ◽

pp. 25-32 ◽

Cited By ~ 6

Author(s):

C Saunte

Keyword(s):

Salivary Glands ◽

Nasal Secretion ◽

Test Battery ◽

The Other ◽

Paroxysmal Hemicrania ◽

Control Group ◽

Innervation Pattern ◽

Autonomic Functions ◽

Chronic Paroxysmal Hemicrania ◽

The One

Autonomic functions have been studied in seven patients with chronic paroxysmal hemicrania (CPH). A test battery comprising tearing, salivation and nasal secretion was employed. Under basal conditions these parameters did not differ significantly from those in a control group. After stimulation with pilocarpine the patients responded rather inhomogeneously. This test battery may therefore help find and classify subgroups of these types of patients. During attacks, there is a clear discrepancy between minimal salivation on the one hand and the marked increase in tearing, nasal secretion and sweating on the other. CPH attacks may be associated with an increased firing of sympathetic impulses to the different organs. In the event of a uniform type of autonomic firing taking place during attack, these findings may suggest a different innervation pattern for the salivary glands compared to the other glands involved. The innervation pattern of these secretory organs may seem to be more intricate and sophisticated than hitherto assumed.

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Chronic Paroxysmal Hemicrania in a Child

Headache The Journal of Head and Face Pain ◽

10.1111/j.1526-4610.1994.hed3409519.x ◽

1994 ◽

Vol 34 (9) ◽

pp. 519-520 ◽

Cited By ~ 29

Author(s):

J. Gladstein ◽

E.W. Holden ◽

L. Peralta

Keyword(s):

Paroxysmal Hemicrania ◽

Chronic Paroxysmal Hemicrania

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Chronic paroxysmal hemicrania

The American Journal of Medicine ◽

10.1016/0002-9343(81)90288-6 ◽

1981 ◽

Vol 71 (1) ◽

pp. 169-170 ◽

Cited By ~ 7

Author(s):

M.Seth Hochman

Keyword(s):

Paroxysmal Hemicrania ◽

Chronic Paroxysmal Hemicrania

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Chronic Paroxysmal Hemicrania in a Patient with a Macroprolactinoma

Cephalalgia ◽

10.1111/j.1468-2982.2006.01101.x ◽

2006 ◽

Vol 26 (6) ◽

pp. 738-741 ◽

Cited By ~ 16

Author(s):

M Sarov ◽

D Valade ◽

C Jublanc ◽

A Ducros

Keyword(s):

International Headache Society ◽

Paroxysmal Hemicrania ◽

Chronic Paroxysmal Hemicrania ◽

International Headache Society Classification

We report a patient with headaches meeting the criteria of chronic paroxysmal hemicrania, as defined by the International Headache Society classification. Headaches were fully responsive to indomethacin during the first 3 months of treatment but recurred when daily doses were lowered. Investigations revealed a macroprolactinoma. Headaches stopped after cabergoline treatment. This report further suggests that patients with paroxysmal hemicrania should be investigated for pituitary abnormalities.

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