title: Preadolescent indomethacin-responsive headaches without autonomic symptoms.
abstract: OBJECTIVE
  A small case series is presented of preadolescent patients with indomethacin-responsive headache.
  
  
  BACKGROUND
  Preadolescent indomethacin-responsive headache is a rare and poorly understood entity, with few published cases in the literature.
  
  
  RESULTS
  Two young children had similar presentations of indomethacin-responsive headaches. Both patients experienced frequent paroxysmal episodes of sudden-onset severe frontal or temporal head pain. The events lasted seconds to minutes in duration, and varied in frequency ranging from multiple episodes per week to multiple events per day. There were no associated autonomic or migrainous symptoms, and a comprehensive work-up revealed no secondary causes for the debilitating headaches. Both patients had dramatic clinical improvement with indomethacin.
  
  
  CONCLUSIONS
  There may be a pediatric syndrome of indomethacin-responsive headache without autonomic symptoms that does not fit well within current diagnostic classifications. More research is needed to determine appropriate dosage and duration of treatment in pediatric indomethacin-responsive headache. Once secondary causes have been ruled out, a trial of indomethacin should be considered in pediatric patients presenting with severe paroxysmal headaches, even if no autonomic symptoms are present.
authors: Pediatrics, Division of Neurology, University of Calgary, Calgary, AB, Canada.
authors: Kenneth Alexis
authors: KA
authors: Myers
authors: Kim A
authors: KA
authors: Smyth
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001341:Autonomic Nervous System / Q000502:physiology; D002675:Child, Preschool; D005260:Female; D006261:Headache / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D008297:Male; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin