title: Is there a relation between hemicrania continua and leprosy?
abstract: The association of hemicrania continua and leprosy has been described in 2008. This relation can be causal or casual. Hemicrania continua is a strictly unilateral, moderate to severe, continuous, indomethacin-responsive primary headache with autonomic cranial symptoms and leprosy is an usual cause of peripheral neuropathy. Prevalence has fallen in the past years, but transmission continues and leprosy remains a public health problem. The objective of this study is to report one case of headache fulfilling the IHS criteria for HC, presented during the course of leprosy. A 61 years old woman started hypo and hiperpigmented lesions with impaired sensation to touch on right side of face (malar). She had biopsy in facial lesion and histopathology compatible with a borderline leprosy form. At the same time, she reported new headaches, daily and continuous, without pain-free periods, unilateral (which were located in the same side of the leprosy lesion in face), throbbing and severe (VAS = 8) with ipsilateral conjuntival injection and lacrimation that improved with indomethacin. We hypothesize that the local injury on the face of this patient predisposes a mechanism of central sensitization, resulting in trigeminal autonomic cephalgia. Relation between trigemino-autonomic cephalalgias and leprosy provides insights into craniofacial pain mechanisms.
authors.affiliation: Headache Clinic, Clinical Hospital, Medical School of Ribeirao Preto, University of São Paulo, Ribeirao Preto, Sao Paulo, Brazil. karenferreira@usp.br
authors.forename: K S
authors.initials: KS
authors.lastname: Ferreira
authors.forename: D J
authors.initials: DJ
authors.lastname: Freitas
authors.forename: J G
authors.initials: JG
authors.lastname: Speciali
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001706:Biopsy; D001938:Brazil; D005145:Face / Q000473:pathology; D005157:Facial Pain / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D015439:Leprosy, Borderline / Q000150:complications* / Q000188:drug therapy / Q000635:transmission; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin