Hemicrania Continua

Medically Reviewed by Murtaza Cassoobhoy, MD on February 13, 2023
2 min read

This rare type of headache doesn't stop. It causes pain on one side of your face or head.

Doctors don’t know what causes this "continuous headache." But women seem to get it more often than men. 

With the right treatment, though, most people can get nearly complete relief from the pain.

People with hemicrania continua describe a dull ache or throb that’s interrupted by pain that is:

  • Jolting
  • Sharp
  • Stabbing

These attacks usually happen three to five times a day.

Some people will have these headaches steadily for months or years. For others, the pain will last for at least 3 months and then will go away for weeks or months, then come back.

The headaches often have some of the same symptoms as other kinds of headaches. This overlap can make them tricky for doctors to diagnose.

Like migraines, they can cause:

  • Nausea or vomiting
  • Sensitivity to noise or light
  • Throbbing pain

Hemicrania continua also shares features of cluster headaches. For example, people who have it may have problems with how part of their nervous system works. That causes symptoms that happen on the painful side of the face and head, including:

  • Stuffy or runny nose 
  • Nosebleeds (which are rare)
  • Tearing, redness, or irritation of the eyes
  • Drooping eyelids
  • Sweating

Some things tend to make symptoms worse, such as:

  • Stress
  • Changes in sleep patterns
  • Bright lights
  • Fatigue
  • Overdoing exercise
  • Alcohol

Some people have symptoms when they:

  • Feel pressure on their neck
  • Flex or rotate their neck

Doctors can make a diagnosis of hemicrania continua if you’ve had pain consistently, without it switching sides or disappearing even briefly, for at least 3 months.

Some anti-inflammatory medications ease hemicrania continua headaches. Indomethacin (Indocin, Tivorbex), a nonsteroidal anti-inflammatory drug (NSAID), often gives fast relief. One way doctors know that you have hemicrania continua is if your headaches go away after a dose of the drug. But some people may need more testing -- such as an MRI -- to look into their symptoms.

Daily doses of indomethacin for hemicrania continua typically range from 25 to 300 milligrams. A common side effect of the drug is irritation of the lining of the stomach and digestive tract. So, people who take it may also need medication to help their stomach make less acid.

If the side effects of indomethacin are too much for you, another NSAID, celecoxib, may also help. 

Tricyclic antidepressants, like amitriptyline, may also prevent these headaches.