Hemicrania continua also shares features of cluster headaches. For example, people with hemicrania continua may have problems with involuntary nervous system functions. Those symptoms, which occur on the affected side of the face and head, may include:
Stuffy or runny nose
Tearing, redness, or irritation of the eyes
Symptoms may be aggravated by many factors, including:
Physical exertion or exercise
In about 10% of patients, an attack may be triggered by:
Applying pressure to the neck
Flexing or rotating the neck
Treatment of Hemicrania Continua
Hemicrania continua headaches respond well to some anti-inflammatory medications. Indomethacin, a nonsteroidal anti-inflammatory drug (NSAID), often provides rapid relief. Doctors consider it a telltale sign of hemicrania continua if the headaches go away after a dose of the drug. However, patients may need special testing -- such as an MRI -- as part of their evaluation.
Daily doses of indomethacin for hemicrania continua typically range from 25 to 200 milligrams. A common side effect of the drug is irritation of the lining of the stomach and gastrointestinal tract. So patients taking indomethacin may also need acid-suppressing medication.
For patients who can't tolerate indomethacin's side effects, another NSAID, celecoxib, may also help.