CASE HISTORY – August 2007

Chronic paroxysmal hemicrania. A case of successful treatment with indomethacin in a 3-year and 10-month-old girl


Articles PDF


Chronic paroxysmal hemicrania is a rare form of headache. CPH usually begins in adulthood and affected persons experience severe throbbing, claw-like or boring pain. The pain is usually on one side of head, near or in the eye, temple, forehead and above the ear, occasionally reaching to the back of the neck. Red and tearing eyes, swollen eyelid of the affected side of the head and nasal congestion may accompany the pain. Patients with CPH experience 10-20 attacks per day on the same side of head, usually lasting 2-25 minutes. Attacks may be triggered by neck movement, external pressure to the neck and other factors. Usually, indomethacin 150 mg per day effectively dissolves and prevents pain attacks.
CPH can occur at any age, affecting predominantly women. CPH is a very rare form of headache in childhood. In the paper a case of a 3-year and ten-month old girl with CPH is described. She had a history of headache since the age of 2 years and three months and was treated with different antiepileptic drugs without any success. She experienced severe pain attacks up to 20 times per day also at nighttime. After indomethacin 25 mg twice per day was prescribed, she became totally symptom free on the seventh day of treatment. Indomethacin 50 mg per day was continued and after three years of follow-up she has not experienced any headache attacs.