Hemicrania Continua Responsive to Botulinum Toxin Type A: A Case Report


Address all correspondence to M. Khalil, Department of Neurology, Hull Royal Infirmary, Kingston-upon-Hull HU3 2JZ, UK.



Hemicrania continua (HC) is a primary headache disorder with full response to indomethacin as one of its diagnostic criteria; however, indomethacin's side effects could limit its use in HC.

Case Result

We report a 33-year-old lady whose headache fulfilled the criteria for HC, but the patient developed gastric side effect to indomethacin and did not respond to other pharmacological treatments; however, injecting botulinum toxin type A has led to complete resolution of all of her symptoms.


We hypothesize the mechanism by which botulinum toxin type A has led to our results through reviewing recent functional neuroimaging findings used to understand the pathophysiology of different primary headache disorders