Chronic paroxysmal hemicrania in an adult responding to valproate: a case report

Autori

  • Daniela Parisi University of Messina, Department of Clinical and Experimental Medicine
  • Giuseppe Vita University of Messina, Department of Clinical and Experimental Medicine
  • Massimo Autunno University of Messina, Department of Clinical and Experimental Medicine

DOI:

https://doi.org/10.6092/1828-6550/APMB.105.2.2017.A3

Parole chiave:

Chronic paroxysmal hemicrania, indomethacin, valproate

Abstract

Chronic paroxysmal hemicrania (CPH) is a rare primary headache syndrome classified as a trigeminal autonomic cephalalgia. It is characterized by repeated attacks of severe, strictly unilateral and short-lasting pain occurring with cranial autonomic features. The absolute response to indomethacin represents the diagnostic key. Unfortunately, often, treatment with indomethacin may cause adverse events, mostly gastrointestinal. We report the case of a 53-year-old male affected by CPH responding to indomethacin, which had to be withdrawn because of gastric side effects. He had a subsequent good and prolonged response to valproate. Our observation suggests the potential use of valproate as a treatment option in patients with CPH with contraindications or intolerance to indomethacin.

Riferimenti bibliografici

The International Classification of Headache Disorders, 3rd edition (beta version) (2013) Cephalalgia, 33(9), 629–808

Pareja, J.A., Caminero, A.B., Franco, E., Casado, J.L., Pascual, J., Sanchez del Rio, M. (2001) Dose efficacy and tolerability of long-term indomethacin treatment of chronic paroxysmal hemicrania and hemicrania continua. Cephalalgia, 21,906–10.

Zhu, Z., McGeeney, B. (2015) When Indomethacin Fails: Additional Treatment Options for “Indomethacin Responsive Headaches”. Curr Pain Headache Rep, 19(3),7

Tarantino, S., Vollono, C., Capuano, A., Vigevano, F., Valeriani, M. (2011) Chronic paroxysmal hemicrania in paediatric age: report of two cases. J Headache Pain, 12(2),263-7.

Coskun, O., Ucler, S., Cavdar, L., Inan, L.E. (2007) Effect of valproic acid on withdrawal therapy in patients with overuse of chronic daily headache medications. J. Clin Neurosci, 14(4),334-9.

Andreou, A.P., Shields, K.G., Goadsby, P.J. (2010) GABA and valproate modulate trigeminovascular nociceptive transmission in the thalamus. Neurobiol Dis, 37(2),314-23.

Goadsby, P.J. (2002) Pathophysiology of cluster headache: a trigeminal autonomic cephalgia. Lancet,1(4),251-7.

Costa, A., Antonaci, F., Ramusino, M.C., Nappi, G. (2015) The Neuropharmacology of ClusterHeadache and other Trigeminal Autonomic Cephalalgias. Curr Neuropharmacol.,13 (3),304-23.

Dowloads

Pubblicato

2017-12-21

Fascicolo

V. 105 N. 2 (2017)

Sezione

CLINICAL CASE SEMINAR

Licenza

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