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Chronic Paroxysmal Hemicrania Presenting as Recurrent Orbital Inflammation


  • Mandagere R. Vishwanath FRCS(Ed),

  • Arpita Jain FRCS(Ed),

  • Fiona Carley FRCOphth

  • From The Manchester Royal Eye Hospital, Manchester, UK (Mr. Vishwanath); and The Royal Oldham Hospital, Oldham, UK (Mrs. Jain, Carley).

Address all correspondence to Mrs. Arpita Jain, Eye Department, Royal Oldham Hospital, Oldham OL1 2JH, UK.


Patients with chronic headache associated with ocular symptoms regularly seek ophthalmologists' opinions. We report an unusual case of chronic paroxysmal hemicrania (CPH), a rare but well-described variant of cluster headache in a female presenting to an eye department with recurrent episodes of severe unilateral periorbital swelling with a chronic history of headaches. Clinical features, review of literature, and therapeutic response to indomethacin helped to establish the diagnosis as CPH. This is the first report of severe orbital inflammation with CPH to our knowledge.