title: Hemicrania continua: functional imaging and clinical features with diagnostic implications.
abstract: This review focuses on summarizing 2 pivotal articles in the clinical and pathophysiologic understanding of hemicrania continua (HC). The first article, a functional imaging project,identifies both the dorsal rostral pons (a region associated with the generation of migraines) and the posterior hypothalamus(a region associated with the generation of cluster and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing [SUNCT]) as active during HC. The second article is a summary of the clinical features seen in a prospective cohort of HC patients that carry significant diagnostic implications. In particular, they identify a wider range of autonomic signs than what is currently included in the International Headache Society criteria (including an absence of autonomic signs in a small percentage of patients), a high frequency of migrainous features, and the presence of aggravation and/or restlessness during attacks. Wide variations in exacerbation length, frequency, pain description, and pain location (including side-switching pain) are also noted. Thus, a case is made for widening and modifying the clinical diagnostic criteria used to identify patients with HC.
authors.forename: Kristen
authors.initials: K
authors.lastname: Sahler
mesh_terms: D005260:Female; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology*; D008297:Male; D008881:Migraine Disorders / Q000503:physiopathology*; D011149:Pons / Q000503:physiopathology*