Chronic paroxysmal hemicrania characteristics include which of the following?

Chronic paroxysmal hemicrania characteristics include which of the following?

• A. Unilateral headache with conjunctival injection and rhinorrhoea, more frequent in women, paroxysms many times per day, with dramatic indomethacin response.
• B. Bilateral headache with no autonomic symptoms.
• C. Migraine-like headache that does not respond to indomethacin.
• D. Cluster headache with no response to indomethacin.

Answer: (A)

Chronic paroxysmal hemicrania is a unilateral trigeminal autonomic cephalalgia with very short, frequent attacks that occur many times per day and are accompanied by ipsilateral autonomic symptoms such as conjunctival injection and rhinorrhoea. It shows a strong female predominance and, most distinguishing, an dramatic and rapid response to indomethacin. This response is so characteristic that it helps confirm the diagnosis. The other patterns—bilateral headaches without autonomic features, migraine-like headaches that don’t improve with indomethacin, or cluster headaches that don’t respond to indomethacin—don’t fit this classic profile.

Chronic paroxysmal hemicrania is a unilateral trigeminal autonomic cephalalgia with very short, frequent attacks that occur many times per day and are accompanied by ipsilateral autonomic symptoms such as conjunctival injection and rhinorrhoea. It shows a strong female predominance and, most distinguishing, an dramatic and rapid response to indomethacin. This response is so characteristic that it helps confirm the diagnosis. The other patterns—bilateral headaches without autonomic features, migraine-like headaches that don’t improve with indomethacin, or cluster headaches that don’t respond to indomethacin—don’t fit this classic profile.