eMedicine Specialties > Neurology > Headache and Pain

Chronic Paroxysmal Hemicrania: Follow-up

Author: Manish K Singh, MD, Assistant Professor, Department of Neurology, Teaching Faculty for Pain Management and Neurology Residency Program, Hahnemann University Hospital, Drexel College of Medicine; Medical Director, Neurology and Pain Management, Jersey Institute of Neuroscience
Coauthor(s): Jashvant Patel, MD, Medical Director, Department of Pain Medicine and Comprehensive Rehabilitation, Medical College of Pennsylvania Hahnemann University
Contributor Information and Disclosures

Updated: Sep 3, 2009

Follow-up

Complications

  • Take precautions to prevent serious gastrointestinal and renal complications secondary to long-term use of indomethacin.

Prognosis

  • In the nonremitting stage of CPH, patients may need lifelong therapy, possibly with smaller doses of indomethacin.
  • Long-lasting remission periods usually reflect a nonchronic stage, but they may occur in patients with established chronic disease.
  • In chronic cases, recurrence of attacks after a drug-free period of 1.5 years has been reported.

Miscellaneous

Medicolegal Pitfalls

  • Appropriate studies should be performed to exclude secondary headache disorders.

Special Concerns

  • CPH attacks have been reported to improve during pregnancy; however, they recur after delivery.
  • Menstruation may have either a positive or negative effect on attacks.
  • Birth control pills do not seem to influence attack frequency.
  • Reliable data do not exist regarding the effects of menopause on CPH.
 


More on Chronic Paroxysmal Hemicrania

Overview: Chronic Paroxysmal Hemicrania
Differential Diagnoses & Workup: Chronic Paroxysmal Hemicrania
Treatment & Medication: Chronic Paroxysmal Hemicrania
Follow-up: Chronic Paroxysmal Hemicrania
References
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Further Reading

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Keywords

Sjaastad syndrome, IHS code: 3.2 chronic paroxysmal hemicrania, ICD-9 code: 346.9 hemicrania, CPH, headache, indomethacin, chronic paroxysmal hemicrania, unilateral headache, headaches with autonomic activation, headaches without autonomic activation, chronic and episodic paroxysmal hemicrania, short-lasting unilateral neuralgiform headache with conjunctival injection and tearing, SUNCT syndrome

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Contributor Information and Disclosures

Author

Manish K Singh, MD, Assistant Professor, Department of Neurology, Teaching Faculty for Pain Management and Neurology Residency Program, Hahnemann University Hospital, Drexel College of Medicine; Medical Director, Neurology and Pain Management, Jersey Institute of Neuroscience
Manish K Singh, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Pain Medicine, American Association of Physicians of Indian Origin, American Headache Society, American Medical Association, and American Society of Regional Anesthesia and Pain Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Jashvant Patel, MD, Medical Director, Department of Pain Medicine and Comprehensive Rehabilitation, Medical College of Pennsylvania Hahnemann University
Jashvant Patel, MD is a member of the following medical societies: Alberta Medical Association, American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American Medical Association, American Society of Regional Anesthesia and Pain Medicine, and Medical Society of the State of New York
Disclosure: Nothing to disclose.

Medical Editor

Jorge E Mendizabal, MD, Consulting Staff, Corpus Christi Neurology
Jorge E Mendizabal, MD is a member of the following medical societies: American Academy of Neurology, American Headache Society, National Stroke Association, and Stroke Council of the American Heart Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

James H Halsey, MD, Professor, Department of Neurology, University of Alabama Medical Center
James H Halsey, MD is a member of the following medical societies: American Academy of Neurology, American Heart Association, American Medical Association, American Neurological Association, American Society of Neuroimaging, Medical Association of the State of Alabama, New York Academy of Sciences, Pan American Medical Association, Sigma Xi, Society for Neuroscience, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Howard A Crystal, MD, Professor, Departments of Neurology and Pathology, State University of New York Downstate; Consulting Staff, Department of Neurology, University Hospital and Kings County Hospital Center
Howard A Crystal, MD is a member of the following medical societies: American Academy of Neurology and American Neurological Association
Disclosure: Medivations Honoraria Consulting

 
 
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