Neuro-Ophthalmologic Presentations of Hemicrania Continua
Accepted 22 July 2005. published online 19 October 2005.
Purpose
We describe a series of patients with hemicrania continua, a rare indomethacin-responsive primary headache syndrome, who presented for evaluation with neuro-ophthalmologic signs and symptoms.
Design
Observational case series.
Methods
Nine patients between the ages of 29 and 58 years were seen with various neuro-ophthalmologic findings and a unilateral continuous headache. A detailed history was taken from each patient, followed by a focused ophthalmologic and neurologic examination. The risks and benefits of treatment with indomethacin were discussed. Patients were instructed to call after several days of treatment to report any change in their headache and neuro-ophthalmologic symptoms, in addition to any adverse side effects.
Results
All patients responded favorably to indomethacin, with rapid near-complete or complete resolution of headache and autonomic symptoms, and treatment was initiated as early as possible.
Conclusions
Because of its absolute response to indomethacin, recognizing the neuro-ophthalmologic symptoms of hemicrania continua as a component of the headache syndrome is critical for prompt initiation of treatment.
aDepartment of Neurology, Yale University School of Medicine, New Haven, Connecticut.
bDepartment of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut.
Inquiries to Robert L. Lesser, MD, 40 Temple Street, New Haven, CT 06510; fax: (203) 937-3801
ABSTRACT