What medication do you consider in patients who cannot take indomethacin or triptans with a diagnosis of Hemicrania Continua?
Is there data for CGRP inhibitors?
Answer from: at Academic Institution
1) DIAGNOSIS
First, ensure you have the correct diagnosis. If purely unilateral but no convincing and significant ipsilateral cranial autonomic symptoms, the much more likely diagnosis is migraine. Also, consider cervicogenic headache in these cases. Hence, you would treat as migraine. If convincin...
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Answer from: at Academic Institution
I agree with the good answer that Dr. @Robblee has given. If the over-the-counter treatments do not work, I would definitely use the gamma core device which is cleared by the FDA for hemicrania continua and paroxysmal hemicrania.
ALAN RAPOPORT, MD