How is Hemicrania Continua diagnosed?

Hemicrania Continua is a rare primary headache disorder characterized by continuous, unilateral (one-sided) head pain that varies in intensity but is always present. Diagnosing Hemicrania Continua can be challenging as its symptoms can mimic other types of headaches. However, there are specific criteria and diagnostic methods that healthcare professionals use to identify this condition.

Diagnostic Criteria

The International Classification of Headache Disorders (ICHD-3) provides the diagnostic criteria for Hemicrania Continua. To receive a diagnosis, a patient must meet the following criteria:

• Unilateral head pain that is continuous and fluctuating in nature for at least three months.


• The pain must be moderate to severe in intensity.


• At least one of the following autonomic symptoms should be present on the same side as the pain:
  
  
  
  • Conjunctival injection (redness of the eye)
  
  
  • Lacrimation (tearing)
  
  
  • Nasal congestion or rhinorrhea (runny nose)
  
  
  • Ptosis (drooping of the eyelid)
  
  
  • Miosis (constriction of the pupil)
  
  
  • Forehead and facial sweating
  
  
  
  


• The response to indomethacin, a nonsteroidal anti-inflammatory drug, should be complete and sustained.


• Other causes of headache must be excluded.

Diagnostic Methods

When a patient presents with symptoms suggestive of Hemicrania Continua, a healthcare professional will typically perform the following diagnostic methods:

1. Medical History: The doctor will inquire about the patient's symptoms, their duration, and any associated features. They will also ask about the response to previous treatments.


2. Physical Examination: A thorough physical examination will be conducted to assess the presence of autonomic symptoms, such as redness of the eye, tearing, runny nose, drooping eyelid, constriction of the pupil, or forehead and facial sweating.


3. Indomethacin Trial: Indomethacin is a medication that is highly effective in treating Hemicrania Continua. A positive response to indomethacin, where the symptoms completely resolve or significantly improve, is a strong indicator of Hemicrania Continua.


4. Imaging Studies: In some cases, imaging studies like magnetic resonance imaging (MRI) or computed tomography (CT) scans may be ordered to rule out other potential causes of the headache.

Consulting a Healthcare Professional

If you suspect you may have Hemicrania Continua or are experiencing persistent, one-sided headaches, it is crucial to consult a healthcare professional. They will evaluate your symptoms, perform the necessary diagnostic tests, and provide an accurate diagnosis. Remember, self-diagnosis is not recommended, as other conditions can present similar symptoms. Early diagnosis and appropriate treatment can significantly improve the quality of life for individuals with Hemicrania Continua.