Co-morbid Indomethacin-Responsive Headaches in a Woman in Her Late 60s With Paroxysmal Hemicrania and Hypnic Headache: A Case Report

Authors

Ashlyn Brown
Randolph W Evans
Claudia Carrizo
Mark Burish

Language

English

Publication Date

1-1-2025

Journal

Cureus

DOI

10.7759/cureus.77243

PMID

39925537

PMCID

PMC11807410

PubMedCentral® Posted Date

1-10-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Paroxysmal hemicrania (PH) and hypnic headache (HH) are rare indomethacin-responsive headache syndromes. This case report details the new onset of both disorders in a woman in her late 60s. One headache type presented as severe pain centered on the right eyebrow, lasting 30 minutes, occurring more than 8 times daily, and associated with ipsilateral lacrimation and rhinorrhea. The second type was a right frontal severe pain, with onset at 4 a.m., occurring only during sleep, lasting 30 minutes, and with no associated factors. The patient's response to indomethacin for both headache types was confirmed through an unblinded ABAB study design: complete resolution of headaches during indomethacin use and recurrence upon discontinuation. This case highlights the rarity of co-morbid indomethacin-responsive headaches and underscores the diagnostic and therapeutic challenges associated with these conditions.

Keywords

headaches disorder, headache treatment, hypnic headache, indomethacin-responsive headaches, indomethacin therapy, paroxysmal hemicrania, trigeminal autonomic cephalalgia

Published Open-Access

yes

Recommended Citation

Brown, Ashlyn; Evans, Randolph W; Carrizo, Claudia; et al., "Co-morbid Indomethacin-Responsive Headaches in a Woman in Her Late 60s With Paroxysmal Hemicrania and Hypnic Headache: A Case Report" (2025). Faculty, Staff and Student Publications. 357.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/357