Hemicrania continua for the headache. When the symptoms of hemicrania continua are present, it's considered "diagnostic" if they respond completely to indomethacin. The efficacy of indomethacin may not be long term for all patients, as can eventually become ineffective. The factor that allows hemicrania continua and its exacerbations to be differentiated from migraine and cluster headache is that hemicrania continua is completely responsive to indomethacin. Triptans and other abortive medications do not affect hemicrania continua. In addition to persistent daily headache of HC, which is usually mild to moderate (and frequently severe), HC can present other symptoms. These additional symptoms of HC
Hemicrania continua topiramate 100–200 mg per day (Topamax) although side effects with this treatment can also prove problematic. Greater occipital nerve (GON) block comprising 40 mg Depomedrone and 10 mls of 1% Lignocaine injected into the affected nerve is effective, up to a period of approximately three months. Changing the 'cocktail' to include (for example) 10 mls of .5% Marcaine and changing to 2% Lignocaine, whilst in theory should increase the longevity, renders the injection completely ineffective. See 4.2 Posology and method of administration (flocculation). Occipital nerve stimulation may be highly effective when other treatments fail to relieve the intractable pain. Hemicrania