Paroxysmal hemicrania
| Chronic paroxysmal hemicrania | |
|---|---|
| ICD-10 code | G44.0 |
| IHS / ICHD-II code | 3.2 |
The paroxysmal hemicrania ( paroxysmal "attack-like"; hemicrania "half head (/ skull) pain") is a headache that is characterized by strictly one-sided pain attacks. The pain is very severe, stabbing and piercing to pulsating, and occurs at least five times a day. In extreme cases, up to 40 attacks per day can occur. Their typical localization is in the eye socket , forehead and / or temple . An attack lasts between 2 and 45 minutes. The diagnostic criteria include the occurrence of one of the following symptoms during the attacks on the affected side: reddening of the conjunctiva , lacrimation , clogging of the nasal mucosa , dripping nose , drooping of the upper eyelid , swelling of the eyelids . Paroxysmal hemicrania differs from the similar cluster headache in that it has shorter but also more frequent seizures and the need to rest during the seizure (while agitation is typical for cluster headaches). The decisive criterion, however, is the therapeutic effectiveness of indomethacin , without which the diagnosis cannot be made. Another differential diagnosis to paroxysmal hemicrania can be migraine or hemicrania continua .
In addition to the chronic form, which is the rule, a few cases of episodic paroxysmal hemicrania have been described, in which frequent pain attacks are followed by symptom-free intervals lasting for weeks to months.
Epidemiology
Women are about three times more likely to be affected. The age of first illness is usually in the third decade of life.
therapy
In addition to indomethacin , verapamil is sometimes prescribed to prevent seizures, but studies currently do not allow a general recommendation. Other analgesics are clearly inferior in effectiveness.
See also
Web links
- Guideline for cluster headache and trigeminal autonomic headache of the German Society for Neurology . In: AWMF online (as of 05/2015)
