Hemicrania continua in a family: A report of two cases

Abstract

Objective To report two cases of hemicrania continua (HC) in a mother and daughter. Background HC is a rare primary headache disorder belonging to the family of trigeminal autonomic cephalalgias (TACs). Unlike migraine, familial cases of TACs are rare, and we know relatively little of their inheritance pattern and genetic mechanisms. Methods We present a mother and daughter with HC. We compare the similarities and differences between this family and the first report of familial HC and discuss the implications for future studies. Results Both the mother and daughter presented with a constant, side‐locked headache of moderate intensity, with episodic exacerbations of more severe pain that are associated with ipsilateral cranial autonomic activation. After negative workup, both patients were started on indomethacin and achieved absolute response at different doses, confirming HC. Conclusions Our report further corroborates other reports of familial TACs that TACs are primary headaches possibly attributable to genetic factors, albeit detailed mechanisms remain elusive. Nevertheless, whether clinical presentation and treatment responses would be substantially different between sporadic and familial HCs remain unclear.

Paroxysmal hemicrania in children and adolescents: A systematic review

“…This study was not included in our review because it did not fulfill the inclusion criteria. There is also a report on hemicrania continua, which belongs to the classification of trigeminal autonomic cephalalgias, in a family (a 44‐year‐old mother presented with hemicrania continua for 32 years and her 23‐year‐old daughter with hemicrania continua for 10 years) 51 . Genetic studies on PH are hampered by small sample sizes.…”