title: Paroxysmal hemicrania: a retrospective study of a consecutive series of 22 patients and a critical analysis of the diagnostic criteria.
abstract: BACKGROUND
  Paroxysmal hemicrania (PH) is a probably underreported primary headache disorder. It is characterized by repeated attacks of severe, strictly unilateral pain lasting 2 to 30 minutes localized to orbital, supraorbital, and temporal areas accompanied by ipsilateral autonomic features. The hallmark of PH is the absolute cessation of the headache with indomethacin. However, these all features may not be present in all cases and a few cases may remain unclassified according to the 2nd Edition of The International classification of Headache Disorders (ICHD-II) criteria for PH.
  
  
  METHODS
  Twenty-two patients were included in this retrospective observation.
  
  
  RESULTS
  We describe 17 patients, observed over six years, who fulfilled the ICHD-II criteria for PH. In parallel, we identified five more patients in whom one of the features of the diagnostic criteria for PH was missing. Two patients did not show any evidence of cranial autonomic feature during the attacks of headache. Another two patients did not fulfill the criteria for PH as the maximum attack frequency was less than five. One patient had an incomplete response to indomethacin.
  
  
  CONCLUSIONS
  A subset of patients may not have all the defined features of PH and there is a need for refinement of the existing diagnostic criteria.
authors.affiliation: Department of Neurology, Medical College, O-19, doctor's quarter, jail road, Baroda, Gujarat, 390001, India. drprakashs@yahoo.co.in
authors.forename: Sanjay
authors.initials: S
authors.lastname: Prakash
authors.forename: Pooja
authors.initials: P
authors.lastname: Belani
authors.forename: Ashish
authors.initials: A
authors.lastname: Susvirkar
authors.forename: Aditi
authors.initials: A
authors.lastname: Trivedi
authors.forename: Sunil
authors.initials: S
authors.lastname: Ahuja
authors.forename: Animesh
authors.initials: A
authors.lastname: Patel
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D051302:Paroxysmal Hemicrania / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin