What is the history of Hemicrania Continua?

Hemicrania Continua is a rare primary headache disorder that was first described in medical literature in 1984 by Dr. Sjaastad and Dr. Antonaci. The term "Hemicrania Continua" was coined by these researchers to describe a chronic headache that is characterized by continuous, unilateral pain on one side of the head.

Historical Background:

Prior to the discovery of Hemicrania Continua, similar headache conditions were often misdiagnosed or classified under other headache disorders. The distinct features of Hemicrania Continua were not well understood, and patients suffering from this condition often faced challenges in receiving an accurate diagnosis and appropriate treatment.

Discovery and Naming:

In 1984, Dr. Sjaastad and Dr. Antonaci published a groundbreaking study that identified and described Hemicrania Continua as a distinct headache disorder. They observed that patients with this condition experienced continuous, moderate to severe pain on one side of the head, along with autonomic symptoms such as tearing, nasal congestion, and drooping of the eyelid.

The researchers named the condition "Hemicrania Continua" to reflect the unilateral nature of the headache (hemicrania) and its continuous presence (continua). This name helped differentiate it from other headache disorders and provided a specific diagnostic term for physicians to use.

Diagnostic Criteria:

Over time, researchers and medical professionals have refined the diagnostic criteria for Hemicrania Continua. The International Classification of Headache Disorders (ICHD) has recognized Hemicrania Continua as a distinct headache disorder since its first edition in 1988.

The current diagnostic criteria for Hemicrania Continua, as outlined in the ICHD-3, include:

• Unilateral headache that is continuous and unremitting for at least three months


• Headache with moderate to severe intensity


• At least one autonomic symptom on the same side as the headache (e.g., redness or tearing of the eye, nasal congestion, drooping of the eyelid)


• Complete response to indomethacin (a nonsteroidal anti-inflammatory drug)


• Headache not better accounted for by another diagnosis

Treatment and Management:

Indomethacin has been found to be highly effective in treating Hemicrania Continua. It is considered the gold standard for both diagnosis and treatment. Most patients with Hemicrania Continua experience complete resolution of their symptoms when treated with indomethacin.

However, some patients may not respond to indomethacin or may experience side effects that limit its long-term use. In such cases, alternative treatments like melatonin, topiramate, or gabapentin may be considered. These medications have shown varying degrees of success in managing Hemicrania Continua symptoms.

Ongoing Research:

While Hemicrania Continua has been recognized as a distinct headache disorder, there is still ongoing research to better understand its underlying causes and develop more effective treatments. Researchers are investigating the role of neuroinflammation, genetic factors, and central nervous system abnormalities in the development of Hemicrania Continua.

Advancements in neuroimaging techniques and genetic studies have provided valuable insights into the pathophysiology of Hemicrania Continua. These findings may lead to the development of targeted therapies that can provide relief to patients who do not respond to traditional treatments.

Conclusion:

Hemicrania Continua is a rare primary headache disorder that was first described in 1984. Its discovery and subsequent naming by Dr. Sjaastad and Dr. Antonaci have greatly contributed to the understanding and recognition of this condition. With improved diagnostic criteria and treatment options, patients with Hemicrania Continua can now receive appropriate care and management for their chronic headaches.