Hemicrania Continua: a Clinical Perspective on Diagnosis and Management

Purpose of Review Hemicrania Continua (HC) is a daily and persistent form of headache that is characterized by side-locked pain which is continuous, varies in severity and can be associated with conjunctival injection, lacrimation, nasal congestion, rhinorrhea, eyelid edema, forehead or facial sweating and miosis and/or ptosis. Recent Findings Functional imaging studies have shown activation of subcortical structures such as the posterior hypothalamus and dorsal rostral pons, which are known to disinhibit the trigeminal autonomic reflex, a reflex responsible for autonomic outflow through trigeminal efferents. A similar pathway activation is seen in other Trigeminal autonomic cephalalgias (TAC) which solidifies HC as a TAC . While we also discuss promising treatments in our review, more evidence is needed before making them a standard of therapy for HC. Summary This article aims to review the recent research on the diagnosis and clinical management of this potentially underdiagnosed primary headache disorder.