From the information that I have it is diagnostic that it is Hemicrania Continua if there is a complete response to the Indomethacin The correct dosage however does have a bearing on this!!
I expect that you're aware of what I'm writing about
, but I feel like it's important to point out. Having a complete response to indomethacin does not prove a diagnosis of Hemicrania continua. It is one of the essential criteria that must be fulfilled for someone to be diagnosed with HC, but the person must also have 1)All of the following characteristics: unilateral pain without side-shift (although there are SOME reports of HC sufferers who do experience side-shifting); daily and continuous, without pain-free periods; and moderate intensity, but with exacerbations of severe pain. As well as 2)At least one of the following autonomic features occurs during exacerbations and ipsilateral to the side of pain: conjunctival injection and/or lacrimation; nasal congestion and/or rhinorrhoea; ptosis and/or miosis. So, if you meet those listed conditions based on your personal experience, the diagnosis for HC is confirmed by a complete response to indomethacin.
So what I think Ann's trying to say is "you will respond completely to indomethacin (aka indocin) if you have HC," not "you have HC if you respond completely to Indomethacin." You may have made this clear in prior posts or your emails, but I just wanted to make sure that it was understood.
The reason for this is because Indomethacin is indicated for all of these clinical conditions--and used for others:
* ankylosing spondylitis
* rheumatoid arthritis
* arthritic gout
* juvenile arthritis
* psoriatic arthritis
* Reiter's syndrome
* Paget's disease of bone
* Bartter syndrome
* dysmenorrhea (menstrual cramps)
* nephrogenic diabetes insipidus (prostaglandin inhibits vasopressin's action in the kidney)
* fever and pain associated with malignant diseases (tumors, bony metastases, lymphogranulomatosis)
* Paroxysmal hemicrania, hemicrania continua and migraine
* renal colic (pain due to kidney stones)
I actually took Indocin for NDPH (at least 100mg QID, though I think it may have been more) with some efficacy.
Anyhow, Ann, I looked back to your earlier post in which you said that "If your headache does turn out to be Hemicrania Continua I am pleased to tell you there is some good news as there is treatment for this called Indomethacin," so I'm sure you're aware of what I'm trying to say. It's just a potentially problematic comment that could possibly lead to misinterpretation by a reader.
Storm, if it seems like you meet the other diagnostic features, as you wrote that you believe you do, then I suggest that you see a headache specialist (it doesn't sound like your GP is qualified to handle whatever it is that you're going through) or at least a neurologist and, after explaining your condition, I'm sure they'll prescribe you some Indomethacin. I'd see someone more qualified than your GP whatever the circumstances end up being. I wish you good luck and good health! And keep listening to Ann regardless of this tiny correction, she's very knowledgeable, especially concerning this subject!
DX: NDPH, Recovered CRPS
RX: Lamictal, Abilify, Verapamil, Provigil, Clonazepam, Ambien CR, Rozerem, Emsam, Namenda
PRN: Haloperidol, Zyprexa, Lodine, Zofran, Oxycodone
Post Edited (korbnep) : 12/2/2007 7:40:57 PM (GMT-7)