Paroxysmal Hemicrania

Diagnosis:

  • Clinical, similar to cluster headache (character & associated symptoms) except:
  • No male predominance
  • Attacks are shorter, more frequent
  • Complete resolution with Indomethacin
  • Episodic & chronic forms

Treatment:

Prophylaxis:

  • Indomethacin up to 200mg (strong evidence base)
  • Verapamil (weak evidence base)
  • NSAIDs (weak evidence base)
  • Topiramate (weak evidence base)

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