Hemicrania Continua and Symptomatic Medication Overuse


  • William B. Young M.D.,

    Corresponding authorSearch for more papers by this author
    • 1Clinical Instructor in Neurology, Temple University School of Medicine, The Comprehensive Headache Center at German-town Hospital, Philadelphia, Pennsylvania

  • Stephen D. Silberstein M.D.

    1. The Comprehensive Headache Center, at Germantown Hospital, Philadelphia, Pennsylvania
    Search for more papers by this author
    • 2Clinical Professor of Neurology, Temple University School of Medicine, Philadelphia, Pennsylvania

William B. Young, M.D., One Penn Boulevard, Philadelphia, PA 19144



Hemicrania continua (HC) is a rare, strictly unilateral, non-paroxysmal headache disorder characterized by its absolute responsiveness to indomethacin. The pain is usually moderate in intensity and frequently associated with a superimposed“jabs and jolts” headache.

We report two cases of HC which presented as chronic daily headache (CDH) with abortive medication overuse.

CDH can be due to transformed migraine (TM), new daily persistent headache (NDPH), chronic tension-type headache, and HC. All can be unilateral, and all can be associated with medication overuse. Our two cases meet the criteria for HC based on indomethacin responsiveness. One meets the criteria for TM, the other NDPH. Is HC a distinct disorder, or a subset of these other disorders? CDH with medication overuse includes in its differential diagnosis HC.