Hemicrania Continua

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What is hemicrania continua?

Hemicrania continua is a chronic and persistent form of headache marked by continuous pain that varies in severity and always occurs on the same side of the face and head. Some individuals with hemicrania continua have bilateral pain, or pain on both sides of the head. Most people experience attacks of increased pain three to five times per 24-hour cycle.

A headache is considered hemicrania continua if the person has had a one-sided daily or continuous headache of moderate intensity with occasional short, piercing head pain for more than three months without shifting sides or pain-free periods. The headache must also be completely responsive to treatment with the non-steroidal anti-inflammatory drug (NSAID) indomethacin. It must have at least one of the following symptoms:  

  • Eye redness and/or tearing
  • Nasal congestion and/or runny nose
  • Ptosis (drooping eyelid)
  • Miosis (contracture of the iris)

Occasionally, individuals will also have forehead sweating and migraine symptoms, such as:

  • Throbbing pain
  • Nausea and/or vomiting
  • Sensitivity to light and sound

There are two forms of hemicrania continua:

  1. Chronic, with daily headaches
  2. Remitting, in which headaches may occur for as long as six months and are followed by a pain-free period of weeks to months until the pain returns

Hemicrania continua occurs on its own and is not a symptom of another disorder. It is more common in women than in men and occurs more often in adult women. Physical exertion and alcohol use may increase the severity of headache pain in some people. The cause of this disorder is unknown.

Indomethacin provides rapid relief from symptoms. Some individuals may need to take acid-suppression medicine due to a gastrointestinal side effect. For those who cannot tolerate the side effects, another NSAID, celecoxib, has been shown to have less complications and can be prescribed. Amitriptyline and other tricyclic antidepressants are also effective in some individuals with hemicrania continua as a preventative treatment.

Individuals with hemicrania continua may obtain complete to near-complete relief of symptoms with proper medical attention and daily medication. Some people may not be able to tolerate long-term use of indomethacin and may have to rely on less effective NSAIDs.

Learn About Clinical Trials
Clinical trials are studies that allow us to learn more about disorders and improve care. They can help connect patients with new and upcoming treatment options.

How can I or my loved one help improve care for people with hemicrania continua?

Consider participating in a clinical trial so clinicians and scientists can learn more about hemicrania continua and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for people with hemicrania continua or other types of headache at Clinicaltrials.gov

Where can I find more information about hemicrania continua?

The following organizations and resources help individuals, families, friends, and caregivers of people living with hemicrania continua and other types of headache:

American Headache Society

National Headache Foundation
312-274-2650 or 888-643-5552


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