Paroxysmal Hemicrania

What is paroxysmal hemicrania?

Paroxysmal hemicrania is a type of headache that causes sudden, severe head pain on one side of your head. You’ll usually feel pain behind your eye.

When headache symptoms happen, it’s also known as a headache attack. Pain and other symptoms of a headache attack come and go in waves that last up to half an hour. You might only feel these waves a few times throughout the day, but some people can experience them up to 40 times per day and last between two to 30 minutes.

This is a primary headache disorder, which means it isn’t caused by an underlying condition.

Paroxysmal hemicrania headaches are treatable. A healthcare provider will help you manage them.

What are the types of paroxysmal hemicrania?

There are two types of paroxysmal hemicrania:

• Chronic: Headache attacks happen daily for a year or longer. Symptom-free periods may happen but last fewer than three months.
• Episodic: There’s a break (more than three months) in between headache attacks.

What are the symptoms of paroxysmal hemicrania?

The most common symptom of paroxysmal hemicrania is a headache with the following features:

• Pain on one side of your head (it doesn’t switch sides).
• Headache symptoms that happen suddenly.
• Pain that lasts up to half an hour.
• Attacks that happen frequently throughout the day.

With a paroxysmal hemicrania headache, you’ll also experience the following symptoms on the same side of your head:

• Eye redness.
• Tearing.
• Runny or stuffy nose.
• Sweating.
• Flushing.
• Restlessness or agitation.
• Eyelid swelling or drooping.

What does paroxysmal hemicrania feel like?

People with paroxysmal hemicrania headaches usually say the pain on one side of their head feels:

• Sharp.
• Intense.
• Squeezing.
• Throbbing.

In between headache attacks, the same side of your head as the headache may feel:

• Dull.
• Sore.
• Tender.

What causes paroxysmal hemicrania?

Experts don’t know exactly why paroxysmal hemicrania happens. Healthcare providers found a connection in several cases between head and/or neck trauma and these headaches.

What triggers paroxysmal hemicrania?

Triggers are things that cause symptoms. Bending or rotating your head or applying pressure to parts of your neck may trigger paroxysmal hemicrania.

What are the risk factors for paroxysmal hemicrania?

Paroxysmal hemicrania can affect anyone. Women and people assigned female at birth are more likely to develop this type of headache. They’re more common in adults than kids and teens, but in general, this is a rare disorder.

How is paroxysmal hemicrania diagnosed?

A healthcare provider will diagnose paroxysmal hemicrania after learning more about your symptoms. They’ll begin with a physical exam. Tell your provider where you experience head pain, how long headache attacks last and how long you experience symptoms.

Your provider may ask you to keep a headache journal. This is a record of your symptoms, when they happen and how you feel.

Testing can help your provider rule out other conditions with similar symptoms. This may include blood tests or an imaging test like an MRI (magnetic resonance imaging) scan.

How is paroxysmal hemicrania treated?

A medication called indomethacin treats paroxysmal hemicrania. This is a nonsteroidal anti-inflammatory drug (NSAID). It reduces inflammation and relieves pain.

There are common side effects of indomethacin like dizziness, vomiting and gastrointestinal problems. Your provider will let you know what side effects to look out for.

Sometimes, side effects or other factors lead your provider to choose another type of medication to treat paroxysmal hemicrania. Alternative options may include:

• Other NSAIDs (aspirin, naproxen and diclofenac).
• COX-2 inhibitors (celecoxib and rofecoxib).
• Calcium channel blockers (verapamil and flunarizine).

Can paroxysmal hemicrania be prevented?

As the cause isn’t well understood, there isn’t a clear way to prevent paroxysmal hemicrania.

What’s the outlook for paroxysmal hemicrania?

Paroxysmal hemicrania is a treatable type of headache. A healthcare provider can help you manage it with medications like indomethacin. It could take some time to find the right dosage for your body’s needs.

There are side effects possible after taking an NSAID long term. Your provider will tell you how often you’ll need follow-up visits to monitor your overall health and make sure you don’t have any new or worsening symptoms. If anything about your treatment plan or how you feel doesn’t seem right, contact your healthcare provider.

What can I expect if I have paroxysmal hemicrania?

Paroxysmal hemicrania can take a toll on your mental health and emotional well-being. Living with severe pain can be challenging. It can interfere with your ability to get out of bed and continue with your routine when a sudden headache happens many times throughout your day. Interruptions from these headache attacks may make you feel trapped or like they’ll never end.

A healthcare provider can help you treat and manage these headache attacks throughout your life.

When should I see a healthcare provider?

Visit a healthcare provider if you have frequent, severe, one-sided headaches without a known cause.

If you have paroxysmal hemicrania, let your provider know if you have new or worsening symptoms or experience any side effects from medications you take.

What questions should I ask my healthcare provider?

• What type of treatment do you recommend?
• How long and how often should I take medication?
• What side effects should I look out for?
• Will these headaches return after treatment?