Kikui Shoji, Miyahara Jun-ichi, Kashiwaya Yoshihiro, Takeshima Takao
Department of Neurology, Tominaga Hospital.
Rinsho Shinkeigaku. 2014;54(10):824-6. doi: 10.5692/clinicalneurol.54.824.
A 51-year-old man complained of continuous pain lasting about 3 weeks around his forehead and left orbit-locations where pain may indicate conjunctival injection and lacrimation. Upon arrival to our hospital, his neurological examination was normal, and brain MRI showed no abnormality. The headache disappeared with indomethacin treatment (75 mg/day), and a diagnosis of hemicrania continua (HC) was established according to the International Classification of Headache Disorders, 2nd Edition. The headache returned after reducing the dose of indomethacin. After adding pregabalin (150 mg/day) to his treatment regimen, we could reduce the dose of indomethacin from 75 mg/day to 25 mg/day, which the patient tolerated well. Although HC is one of the indomethacin-responsive headaches, continuous administration can cause side effects including gastrointestinal disorders. Such side effects can decrease the tolerability of indomethacin, and may eventually lead to its reduction or discontinuation. Pregabalin can be an alternative to indomethacin for treating HC.
一名51岁男性主诉前额和左眼眶周围持续疼痛约3周，疼痛部位可能出现结膜充血和流泪。入院时，他的神经系统检查正常，脑部MRI未显示异常。使用吲哚美辛治疗（75毫克/天）后头痛消失，根据《国际头痛疾病分类》第二版，确诊为持续性偏侧头痛（HC）。减少吲哚美辛剂量后头痛复发。在治疗方案中加用普瑞巴林（150毫克/天）后，我们能够将吲哚美辛剂量从75毫克/天减至25毫克/天，患者耐受性良好。虽然HC是对吲哚美辛有反应的头痛之一，但持续用药会引起包括胃肠道疾病在内的副作用。这些副作用会降低对吲哚美辛的耐受性，并最终可能导致其减量或停药。普瑞巴林可作为治疗HC的吲哚美辛替代药物。
