What is chronic paroxysmal hemicrania (CPH)?
Chronic paroxysmal hemicrania (CPH) may be a variant form of cluster headache; it is frequently confused with it and responds quickly to indomethacin (Indocin). CPH was first described by Sjaastad and Dale in 1974. The condition occurs primarily in women, and sometimes young girls, and the attacks, unlike cluster headaches, may be precipitated by bending the neck and occasionally by rotation of the neck. It rarely responds to medications that are effective for cluster headache. The originally described pattern was characterized by multiple, short-lived, one-sided attacks occurring daily and without remission. Subsequently, Kudrow et al. described an episodic form in which headache phases were separated by prolonged pain-free remissions. This form was referred to as episodic hemicrania (Kudrow, 1987). The pattern may evolve from intermittent to continuous (chronic). Though rare, there are more than 100 cases of CPH in the literature. The chronic form seems to be more common than the epi
