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Keywords:

  • hemicrania continua;
  • chronic paroxysmal hemicrania;
  • indomethacin

It is known that in hemicrania continua the chronic stage may be preceded by a remitting stage. In the present communication, the reverse sequence has been demonstrated, ie, a transition from the chronic to the remitting stage. The headache was characterized by a chronic pattern from the beginning until the commencement of indomethacin treatment, which provided long-lasting relief. Withdrawal of the drug resulted in reappearance of headaches with the same clinical features but in a remitting fashion. Resumption of indomethacin treatment had a dramatic effect on the remitting headaches. Such a temporal evolution of symptoms is consistent with the prevailing view that in a patient with hemicrania continua, there may be two temporal patterns.