Diagnose and adios: practical tips for the ongoing evaluation and care of TAC patients taking indomethacin

Curr Pain Headache Rep. 2015;19(2):470. doi: 10.1007/s11916-014-0470-z.

Abstract

Paroxysmal hemicrania and hemicrania continua are primary headache disorders characterized by unilateral attacks of severe pain around the orbit with associated autonomic features. They are unique in their absolute response to indomethacin. Diagnosis is made when patients with suspected paroxysmal hemicrania or hemicrania continua have the resolution of headache with therapeutic doses of indomethacin. Once diagnosis is made, limited data exists on the ongoing management of these patients. For patients who do not tolerate indomethacin, or wish to come off medication, there remain few options. This article will discuss the diagnosis of paroxysmal hemicrania and hemicrania continua and the ongoing management of patients on indomethacin, as well as options for patients who do not tolerate or need to come off indomethacin.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Autonomic Nervous System / drug effects
  • Autonomic Nervous System / physiopathology*
  • Chronic Disease
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Headache Disorders / diagnosis*
  • Headache Disorders / drug therapy
  • Humans
  • Indomethacin / therapeutic use*
  • Neurologic Examination
  • Paroxysmal Hemicrania / diagnosis*
  • Paroxysmal Hemicrania / drug therapy
  • Recurrence

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Indomethacin