Successful treatment of indomethacin-intolerant chronic paroxysmal hemicrania: report of two cases

Chronic paroxysmal hemicrania (CPH) is a rare headache syndrome resulting in non-remitting, recurrent, intense, short-lasting pain, with typical, often total, responsiveness to indomethacin. Other drugs have anecdotally been reported to be potentially effective. Apparent unreponsiveness, in fact due to intolerance to this non-steroidal antiinflammatory drug, can lead to doubt about the initial diagnosis. Two such cases of CPH, for whom effective alternative treatment was eventually given, are described.