title: Hemicrania continua in a headache clinic: referral source and diagnostic delay in a series of 22 patients.
abstract: Hemicrania continua (HC) is a unilateral and continuous primary headache with superimposed exacerbations frequently associated with autonomic features. Diagnostic criteria of HC, according to II Edition of International Classification of Headache Disorders require complete response to indomethacin. HC is probably misdiagnosed more often than other primary headaches. We aim to analyze characteristics of a series of 22 consecutive cases of HC. We recruited patients from a headache outpatient clinic in a tertiary hospital over a 3-year period (January 2008 to January 2011). We prospectively gathered demographic and nosological characteristics and considered referral source and delay between onset of headache and diagnosis of HC. Twenty-two patients (14 females, 8 males) out of 1,150, who attended the mentioned clinic during the inclusion period (1.9 %) were diagnosed with HC. All cases responded to indomethacin. No patient received a diagnosis of HC before attending our headache office. Mean latency of diagnosis was 86.1 ± 106.5 months (range 3-360). 11 patients (50 %) were referred from primary care, with 9 (40.9 %) from other neurology clinics and 2 (9.1 %) from other specialities offices. According to our series, HC is not an infrequent diagnosis in a headache outpatient clinic. Diagnostic delay is comparable to data collected in previous studies. As HC is frequently misdiagnosed, we thing there is a need for increasing the understanding of this entity, potentially responsive to indomethacin.
authors: Neurology Department, Hospital Clínico Universitario, Avda Ramón y Cajal 3, 47005 Valladolid, Spain.
authors: Elisa
authors: E
authors: Cortijo
authors: Angel L
authors: AL
authors: Guerrero
authors: Sonia
authors: S
authors: Herrero
authors: Patricia
authors: P
authors: Mulero
authors: Irene
authors: I
authors: Muñoz
authors: María I
authors: MI
authors: Pedraza
authors: María L
authors: ML
authors: Peñas
authors: Esther
authors: E
authors: Rojo
authors: Dulce
authors: D
authors: Campos
authors: Rosa
authors: R
authors: Fernández
mesh_terms: D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D020773:Headache Disorders / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D008297:Male; D012017:Referral and Consultation; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin