How is chronic paroxysmal hemicrania diagnosed
Once the diagnosis of episodic or chronic paroxysmal hemicrania is established, are any further workups necessary?
Although the PHs are benign by definition, there have been patients with clear medical or structural etiologies of this clinical disorder. For example, to date, there have been a number of published cases of patients with CPH-like headaches associated with collagen vascular diseases, malignant brain tumors, arteriovenous malformations, and ischemic stroke. Neuroimaging is therefore recommended in all cases with the presumptive diagnosis of either CPH or EPH in those patients presenting for the first time or in those presenting with a change in their typical pattern, to exclude other causes of these rare headaches. Several of these patients have also responded to indomethacin.
