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Paroxysmal hemicranium

 
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Last reviewed: 23.04.2024
 
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Paroxysmal hemicrania is manifested by attacks with pain characteristics and concomitant symptoms similar to those with headache. Distinguishing symptoms are short-term attacks and their high frequency. Paroxysmal hemicranium is more often observed in women, usually the disease begins in adulthood, but cases in children are also described. A specific feature of this form of cephalalgia is the effectiveness of indomethacin. Diagnostic criteria are presented below.

Paroxysmal hemicranium (MKGB-4)

  • A. At least 20 seizures that meet BD criteria.
  • B. Attacks of intense unilateral pain of orbital, supraorbital or temporal localization lasting 2-30 minutes.
  • C. Headache is accompanied by at least one of the following symptoms:
    • ipsilateral injections of conjunctiva and / or lacrimation;
    • ipsilateral neuralgia and / or rhinorrhea:
    • ipsilateral swelling of the eyelids;
    • ipsilateral sweating of the forehead and face;
    • ipsilateral miosis and / or ptosis.
  • D. The prevalence of seizures is more than five times a day, sometimes somewhat less frequently.
  • E. The seizures are completely prevented by the ingestion of indomethacin in a therapeutic dose.
  • F. Not related to other causes (violations).

As well as with bundle hungry pain, there is an episodic (with remissions of 1 month or more) and a chronic form of paroxysmal hemicrania, in which the seizures are repeated for more than 1 year without remissions or with remissions of less than 1 month. There are cases of paroxysmal hemicrania, combined with trigeminal neuralgia (the so-called paroxysmal hemicrania-tick syndrome).

trusted-source[1], [2], [3], [4], [5]

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Treatment of paroxysmal hemicrania

Specific therapy paroxysmal hemicrania - the use of indomethacin (inside or rectally at a dose of at least 150 mg / day or at least 100 mg in the form of injection). For maintenance therapy, smaller doses are also often effective.

More information of the treatment

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