Chronic paroxysmal hemicrania coexisting with migraine. Differential response to pharmacological treatment.

A 30 year old woman, suffering from migraine for 14 years, started having chronic paroxysmal hemicrania (CPH) attacks at the age of 29. Both types of headache coexisted for a year without any apparent influence of one type on the other. Treatment with indomethacin had a dramatic effect on the CPH attacks but did not modify the course of the migraine. The independent clinical courses and the differential response to indomethacin are consistent with the knowledge that both types of headache are different and that there is no relationship between them. Owing to the high prevalence of migraine it is likely that some CPH sufferers may have a familial or personal history of migraine; therefore the conjunction of CPH and migraine occurs by chance.