Hemicrania Continua: Symptoms, Causes and Treatment

Hemicrania Continua

The condition of hemicrania continua involves continuous pain on one side of the head for an extended period of time. Chronic headaches are primary headaches, which means they do not occur as a result of another condition or disease. Typically, the pain lasts more than a month, alternating with periods of severe pain.

There are two types of hemicrania: chronic and remitting. An individual suffering from chronic hemicrania is plagued with daily headaches. Hemicrania remits refers to periods when there are no headaches followed by recurrent headaches lasting up to six months.

Read on to learn about the symptoms, causes, treatment, and outlook of hemicrania continua.

Read: Migraine Headache

Difference between hemicrania continua and a migraine

Migraines and hemicrania continua can have similar symptoms. Typically, hemicrania continua only affects one side of the face. A constant headache is also a hemicranial headache.

Migraine symptoms, on the other hand, are temporary. There’s no specific part of your face or head that gets migraines.

Difference between hemicrania continua and paroxysmal hemicrania

Both paroxysmal hemicrania and continual hemicrania affect one side of your face. A persistent headache called hemicrania continua lasts a long time or never goes away. It’s a headache that happens repeatedly and suddenly.

Hemicrania continua symptoms

Chronic hemicrania continua is characterized by a dull headache lasting for days or weeks on one side of the head. However, it can affect both sides of the head in some individuals.

An occasional throbbing pain will also occur on the same side of the head as the dull ache.

The following symptoms must be experienced by the sufferer in order to be diagnosed with hemicrania continua:

  • Redness or tearing of the eyes
  • Miosis (contracture of the iris)
  • Nasal congestion
  • Ptosis (drooping of the eyelids)
  • Runny nose
  • Intense restlessness or pain when moving

Other symptoms that may occur include headache-like symptoms like forehead sweating and migraine-like symptoms like:

  • Vomiting
  • Throbbing pain
  • Sound and light sensitivity
  • Nausea

Read: Tension Headaches

Causes and triggers

The exact cause of hemicrania continua is unknown, according to the National Institute of Neurological Disorders and Stroke.

Some people living with MS may experience worsening pain due to two factors – alcohol consumption and physical exertion. However, the Migraine Trust points out that the triggers of the condition are not clear.

Potential risk factors

The factors associated with hemicrania continua are as obscure as the triggers for the condition. Hemicrania continua is more common in biological females than in biological males, notes the Genetic and Rare Diseases Information Center. It’s usually diagnosed in adults, but it can begin at any age between 5 and 67.


Hemicrania continua can be diagnosed using clear criteria provided by the International Headache Society. A person must also suffer from the following in addition to only feeling pain on one side of the head:

  • A chronic, dull headache lasting three months or more.
  • Indomethacin can relieve headaches with therapeutic doses.
  • It is recommended that the patient exhibits at least one additional symptom, which may include a runny nose, ptosis, nasal congestion, restlessness, miosis or red eyes or tears.

It must also be apparent that the headache and associated symptoms are not due to another type of headache or are better explained by another type of headache.

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Hemicrania continua treatment

Hemicrania continua is treated by preventing the disease. It cannot be cured. An NSAID (nonsteroidal anti-inflammatory drug) that is the most effective treatment for this condition is indomethacin. The dose of indomethacin should be 25–300 milligrams daily for at least an indefinite period of time for it to be effective.

Domethacin is so effective at proper doses that doctors might even utilize it for diagnosis. Hemicrania continua may not occur when indomethacin does not provide relief for a headache.

It may not be suitable for everyone to take indomethacin. Medications that reduce gastrointestinal complications may be prescribed by a doctor for mild side effects.

Several types of NSAIDs are available, including celecoxib, which has minimal side effects. In addition, amitriptyline or another tricyclic antidepressant may be prescribed by your doctor to prevent headache pain.

Are there side effects of indomethacin?

Indomethacin doesn’t cause side effects for most people. There are other things you might experience:

  • Fatigue
  • Changes in mood, like depression
  • Nausea

There’s also a chance Indomethacin will lead to ulcers. The medication your provider prescribes may protect the lining of your stomach from ulcers.

When to visit a doctor

Patients must present a history of continuous pain for at least three months before a doctor can diagnose hemicrania continua.

Keeping a headache journal and consulting a doctor when a person has a dull and one-sided headache should be considered when a person reaches the 3-month mark.

When a person experiences a severe headache combined with fever or other concerning symptoms, they should seek medical attention as soon as possible. It is possible for severe headaches to be symptoms of more serious health conditions that need immediate medical care.

If hemicrania continua is diagnosed, a person may want to continue keeping a headache journal. It can be helpful to gauge whether the treatment is effective.

Also, if you experience side effects from taking a medication, it is important to talk with your doctor about alternatives.

Read: Difference Between Sadness and Depression


Chronic hemicrania continua cannot be cured; however, one can prevent it from returning by using preventative medications continuously. The side effects of indomethacin may vary for individual patients. The person should discuss other treatment options with their doctor if side effects occur. These may be effective in preventing headache pain.


Occasionally, hemicrania continua can cause severe headaches on one side of the head and can continue for weeks or months. Domethacin, a type of NSAID, is one of the most effective treatments.

If pain is to be prevented, the medication must be taken on a consistent basis indefinitely. Alternative medications should be considered by patients who are unable to tolerate the treatment course. These medications will help prevent pain from returning.

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