Conflicts of Interest: None to declare.
Hemicrania Continua: Functional Imaging and Clinical Features With Diagnostic Implications
Article first published online: 10 APR 2013
© 2013 American Headache Society
Headache: The Journal of Head and Face Pain
Volume 53, Issue 5, pages 871–872, May 2013
How to Cite
Sahler, K. (2013), Hemicrania Continua: Functional Imaging and Clinical Features With Diagnostic Implications. Headache: The Journal of Head and Face Pain, 53: 871–872. doi: 10.1111/head.12095
- Issue published online: 24 APR 2013
- Article first published online: 10 APR 2013
- Manuscript Accepted: 24 FEB 2013
- hemicrania continua;
- trigeminal autonomic cephalalgia;
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 International Headache Society 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.