Get access

Prophylaxis of Hemicrania Continua: Two New Cases Effectively Treated With Topiramate


  • Filippo Brighina MD,

  • Antonio Palermo MD,

  • Giuseppe Cosentino MD,

  • Brigida Fierro MD

  • From the Department of Neurology, University of Palermo, Palermo, Italy.

  • Address all correspondence to Filippo Brighina, Department of Neurology, University of Palermo, via G. La Loggia, 1 Palermo, Italy 90129.


Hemicrania continua (HC) is an uncommon and under-recognized primary headache disorder characterized by a strictly unilateral continuous headache of moderate intensity with possible exacerbations and associated with ipsilateral autonomic features. HC has generally a prompt and enduring response to indomethacin although 25% to 50% of treated patients develop gastrointestinal side effects. These cases pose a difficult management challenge as no other drug is consistently effective in HC. Recently 2 HC patients responsive to topiramate treatment have been reported. Here we describe 2 more patients effectively treated with topiramate. Neither reported any side effects and one had persisting response for 6 months after drug withdrawal.