Hemicrania Continua

Headache (R Halker, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Headache


In recent years, hemicrania continua has become a well-recognized primary headache disorder known for its chronicity and resulting disability in a subset of patients with headache. The core clinical features have been well described: unilateral, side-locked headaches that are continuous (although interrupted by frequent severe exacerbations), associated with autonomic symptoms and a response to indomethacin. However, areas of relative controversy remain in its classification and diagnosis. Several relatively large case series have better delineated the associated features of this disorder, including atypical presentations. Recently, neuroimaging research has provided new insights into the underlying pathways involved in the disorder, in particular activation of the contralateral posterior hypothalamus and the ipsilateral dorsal rostral pons. Despite its well-known response to indomethacin, many patients still endure long delays in the appropriate diagnosis and treatment. There remains a need for new treatments given the morbidity associated with long-term indomethacin use.


Hemicrania continua Unilateral headache Review Trigeminal autonomic cephalalgia Indomethacin-responsive headache 


Compliance with Ethics Guidelines

Conflict of Interest

Robert W. Charlson declares that he has no conflict of interest.

Matthew S. Robbins has received payment for manuscript preparation from MedLink Neurology and the American College of Physicians (PIER module). He has also received book royalties from Wiley (Headache) and payment for development of educational presentations from the American Headache Society and Prova Education.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Neurology, Montefiore Medical CenterAlbert Einstein College of MedicineBronxUSA
  2. 2.Montefiore Headache Center, Department of NeurologyAlbert Einstein College of MedicineBronxUSA

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