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Posted by Paco on November 07, 2001 at 10:36:30:

In Reply to: Important post. posted by hub on November 07, 2001 at 06:18:52:

...post the following excerpt. If your attacks fit the description, you should obviously try a medicine that has proven to be (almost) 100% effective. Chronic paroxysmal hemicrania Description (IHS): Attacks with largely the same characteristics of pain and associated symptoms and signs as cluster headache, but they are shorter lasting, more frequent, occur mostly in females, and there is absolute effectiveness of indomethacin, as shown in the description of a patient with chronic paroxysmal hemicrania. Diagnostic criteria (IHS) (abbreviated and slightly altered) A.At least 50 attacks B.Attacks of severe unilateral orbital, supraorbital and/or temporal pain always on the same side lasting 2 to 45 minutes C.Attack frequency above 5 per day for more than half of the time D.Pain is associated with at least one of the following symptoms on the pain side: 1.conjunctival injection (reddened eyeball) 2.Lacrimation (excessive tears from the eye) 3.Nasal congestion (stuffy nose) 4.Rhinorrhea (runny nose) 5.Ptosis (lowered upper eyelid) 6.Eyelid edema (lids become puffy) E.Absolute effectiveness of indomethacin (150 mg per day or less) F.Secondary headache types neither suggested nor confirmed Comment: Just as cluster headache has both an episodic and chronic form, so does paroxysmal hemicrania. Its episodic form is called episodic paroxysmal hemicrania. Its first identification was just before the IHS published its headache classification in 1988. It's rarer even than the chronic form. Its individual headache attacks are identical to those of the chronic form, from which it differs only by its remissions of months to years between bouts of attacks. Goadsby and Lipton (1997) have reviewed the literature on the paroxysmal hemicranias and proposed diagnostic criteria for both forms. The IHS requires disappearance of the headache attacks of chronic paroxysmal hemicrania during indomethacin therapy, in a dose of 150 mg or less per day, for the diagnosis to be established. But this criterion has been challeged, in view of reports of a few patients whose headaches responded partially or not at all to indomethacin, even though their headaches were otherwise typical of chronic paroxysmal hemicrania.

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