Hemicrania Continua Headache - Symptoms & Causes

What is hemicrania continua?

Hemicrania continua is a rare headache disorder characterised by continuous, unilateral (one-sided) head pain that varies in intensity. The headache is present for most of the day, for at least 3 months. This condition is unique because the pain is constant, though the intensity of the pain can fluctuate.

One unique feature is it responds absolutely to indomethacin.

What are the types of hemicrania continua?

Hemicrania continua is typically considered a single type of headache disorder but with two subtypes:

• Continuous hemicrania continua is a persistent, unrelenting headache that occurs daily with varying intensity throughout the day.
• Remitting hemicrania continua involves periods of continuous headache lasting months or years, followed by remission periods with no pain.

What are the symptoms of hemicrania continua?

Symptoms of hemicrania continua include:

• Persistent, continuous headache on one side of the head
• Pain that varies in intensity but is always present
• Periods of exacerbation where the pain becomes more severe
• Autonomic symptoms on the affected side, such as:
  • Tearing or redness of the eye
  • Nasal congestion or runny nose
  • Drooping eyelid (ptosis) or constricted pupil (miosis)
• Sensitivity to light (photophobia) and sound (phonophobia)
• Nausea and vomiting

When to seek medical attention?

You should seek medical attention if:

• You experience a persistent, unilateral headache that does not respond to typical over-the-counter pain medications
• The headache is accompanied by autonomic symptoms such as tearing or nasal congestion
• The headache interferes with daily activities and reduces your quality of life
• You experience new or worsening symptoms (vision changes, fever, weakness)
• There is a sudden change in the pattern or intensity of your headaches

What causes hemicrania continua?

The exact cause of hemicrania continua is not well understood. It is considered a primary headache disorder. Unlike many types of headache disorders, environmental factors like stress or lack of sleep don’t trigger symptoms.

What are the complications of hemicrania continua?

Hemicrania continua headache is not life-threatening, but chronic pain and its management can affect daily functioning and reduce quality of life.