Indomethacin-intolerant hemicrania continua:treatment with botulinum toxin

[摘要] Hemicrania continua (HC) is responsive to indomethacin, which is useful both for acute treatmentand for chronic suppressive therapy. However, this medication is poorly tolerated in many patients.The treatment of indomethacin-intolerant HC is poorly defined. We present a patient with HC whodeveloped acute kidney injury on indomethacin and proved refractory to multiple other treatmentmodalities. She had an excellent response to botulinum toxin, with a duration of benefit similar to thatreported previously in HC and in chronic migraine. Botulinum toxin may be a therapeutic option inpatient with HC who do not tolerate indomethacin. The possible mechanisms of action of botulinumtoxin in HC are discussed.

[学科分类] 精神健康和精神病学

[关键词] Hemicrania continua;indomethacin;botulinum toxin