title: Chronic paroxysmal hemicrania in paediatric age: report of two cases.
abstract: Chronic paroxysmal hemicrania (CPH) is a rare primary headache syndrome, which is classified along with hemicrania continua and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) as trigeminal autonomic cephalalgia (TACs). CPH is characterised by short-lasting (2-30 min), severe and multiple (more than 5/day) pain attacks. Headache is unilateral, and fronto-orbital-temporal pain is combined with cranial autonomic symptoms. According to the International Classification of Headache Disorders, 2nd edition, the attacks are absolutely responsive to indomethacin. CPH has been only rarely and incompletely described in the developmental age. Here, we describe two cases concerning a 7-year-old boy and a 11-year-old boy with short-lasting, recurrent headache combined with cranial autonomic features. Pain was described as excruciating, and was non-responsive to most traditional analgesic drugs. The clinical features of our children's headache and the positive response to indomethacin led us to propose the diagnosis of CPH. Therefore, our children can be included amongst the very few cases of this trigeminal autonomic cephalgia described in the paediatric age.
authors.affiliation: Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy. gone.st@libero.it
authors.forename: Samuela
authors.initials: S
authors.lastname: Tarantino
authors.forename: Catello
authors.initials: C
authors.lastname: Vollono
authors.forename: Alessandro
authors.initials: A
authors.lastname: Capuano
authors.forename: Federico
authors.initials: F
authors.lastname: Vigevano
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Valeriani
mesh_terms: D000367:Age Factors; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D002648:Child; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage; D004334:Drug Administration Schedule; D006801:Humans; D007213:Indomethacin / Q000008:administration & dosage*; D008297:Male; D051302:Paroxysmal Hemicrania / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D055502:Secondary Prevention; D051303:Trigeminal Autonomic Cephalalgias / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D007213:Indomethacin