Cluster headache responsive to indomethacin: Case reports and a critical review of the literature

@article{Prakash2010ClusterHR,
  title={Cluster headache responsive to indomethacin: Case reports and a critical review of the literature},
  author={Sanjay Prakash and Nilima Deepak Shah and Bhavna V Chavda},
  journal={Cephalalgia},
  year={2010},
  volume={30},
  pages={975 - 982}
}
Introduction: Response to indomethacin is an essential feature for the diagnosis of both paroxysmal hemicrania (PH) and hemicrania continua (HC). Cluster headache (CH) is widely considered to be a disease unresponsive to indomethacin. Case reports: We report four patients with CH who responded to indomethacin. Two patients, who were refractory to the usual therapy for CH, fulfilled the criteria for chronic CH. Conversely, two patients had a history of episodic CH and showed response to both… 

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References

SHOWING 1-10 OF 58 REFERENCES
A Patient with Cluster Headache Responsive To Indomethacin: Any Relationship with Chronic Paroxysmal Hemicrania?
TLDR
This case report describes a CH patient responsive to indomethacin, suggesting that the drug might provide a further chance to treat the active CH period, given that controlled clinical trials are provided and that CH and PH share some pathophysiological mechanisms.
A Patient With Chronic Cluster Headache Responsive to High-Dose Indomethacin: Is There an Overlap With Chronic Paroxysmal Hemicrania?
TLDR
A case of C CH responding to high-dose indomethacin when other treatments failed and the relationship of CCH to CPH is reported, which is incumbent on the clinician to exhaust all potential medical options.
Parenteral Indomethacin (The Indotest) in Cluster Headache
TLDR
The use of a test dose of 100 mg i.m. indomethacin (INDOTEST) appears to provide a clear-cut answer in this situation and may be a useful tool for a proper clinical assessment of unilateral headache with relatively short-lasting attacks when problems of classification arise.
Cluster Headache and Paroxysmal Hemicrania: Differential Diagnosis
TLDR
Clinical features that distinguished cluster headache and paroxysmal hemicrania patients were: maximal pain localization, ocular in CH patients and extra-ocular in PH group; mean attack duration was longer and mean attack frequency was lower inCH patients in comparison with PH patients.
Paroxysmal hemicrania and cluster headache: two discrete entities or is there an overlap?
TLDR
There is increasing evidence that paroxysmal hemicrania and cluster headache share a similar pathogenesis and that they may not always be so discrete in either their response to indomethacin or their periodicity.
Differentiating Paroxysmal Hemicrania from Cluster Headache
  • C. Boes
  • Medicine
    Cephalalgia : an international journal of headache
  • 2005
‘The first case of chronic paroxysmal hemicrania (CPH), a female aged 44 years with a 9-year history of headache, was brought to our cognizance in 1961, with a diagnosis of ‘typical cluster
Coexistence of cluster headache and paroxysmal hemicrania: does it exist? A case report and literature review
TLDR
A 22-year-old male who had cluster headache and chronic paroxysmal hemicrania since the onset of symptoms responded to indomethacin.
Chronic cluster headache: a French clinical descriptive study
TLDR
This study confirms the existence of auras and interictal signs and symptoms in patients with chronic CH, and male sex and smoking as CH risk factors, and primary and secondary chronic CH appear equally prevalent.
EVIDENCE FOR A NEW (?), TREATABLE HEADACHE ENTITY A PRELIMINARY REPORT
TLDR
The corneal indentation pulse amplitudes were higher than normal during attacks both in the authors' two patients and in regular cluster headache cases.
Cluster headache in children--experience from a specialist headache clinic.
  • A. Majumdar, M. S. Ahmed, S. Benton
  • Medicine, Psychology
    European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society
  • 2009
...
...