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Hemicrania Continua: Functional Imaging and Clinical Features With Diagnostic Implications
Author(s) -
Sahler Kristen
Publication year - 2013
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.12095
Subject(s) - medicine , cluster headache , exacerbation , pathophysiology , dorsum , fibromyalgia , cohort , anesthesia , migraine , physical therapy , anatomy
This review focuses on summarizing 2 pivotal articles in the clinical and pathophysiologic understanding of hemicrania continua ( HC ). The first article, a functional imaging project, identifies both the dorsal rostral pons (a region associated with the generation of migraines) and the posterior hypothalamus (a region associated with the generation of cluster and short‐lasting unilateral neuralgiform headache with conjunctival injection and tearing [SUNCT]) as active during HC . The second article is a summary of the clinical features seen in a prospective cohort of HC patients that carry significant diagnostic implications. In particular, they identify a wider range of autonomic signs than what is currently included in the I nternational H eadache S ociety criteria (including an absence of autonomic signs in a small percentage of patients), a high frequency of migrainous features, and the presence of aggravation and/or restlessness during attacks. Wide variations in exacerbation length, frequency, pain description, and pain location (including side‐switching pain) are also noted. Thus, a case is made for widening and modifying the clinical diagnostic criteria used to identify patients with HC .