Chronic paroxysmal hemicranias (CPH) is a rare neurological disorder characterized by recurrent episodes of severe headache on one side of the head. These headaches occur in a paroxysmal pattern, meaning they have sudden onset and occur in repeated attacks. The pain experienced during these attacks is intense, typically described as sharp, piercing, or stabbing. Individuals with CPH often report accompanying symptoms, such as eye redness, nasal congestion, tearing, and facial sweating, on the same side as the headache.
CPH is classified as a primary headache disorder, meaning it occurs without any underlying structural abnormalities or secondary causes. It is thought to be related to dysfunction in the trigeminal autonomic reflex pathway, which regulates the blood vessels, nerves, and muscles involved in headache generation.
The frequency and duration of CPH attacks can vary among individuals, but they typically last 2-45 minutes and occur multiple times per day, often awakening the person from sleep. CPH is a chronic condition, meaning it persists over a prolonged period, with periods of remission and exacerbation.
Diagnosis of CPH requires a thorough medical evaluation to rule out other possible causes of the headaches. Treatment options for CPH include medications that target and modulate the trigeminal autonomic reflex pathway, such as indomethacin or other non-steroidal anti-inflammatory drugs (NSAIDs). In some cases, nerve blocks or surgery may be considered for individuals who do not respond to medication.
