How is chronic paroxysmal hemicrania (CPH) differentiated from nonchronic PH?

Updated: Jun 12, 2019
  • Author: Monica Saini, MD, MBBS; more...
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PH may be present in nonchronic or chronic form, although the chronic type is 4 times more common. Approximately 65%–85% of patients with PH have the chronic form. [5]

Nonchronic attacks are similar to chronic ones but tend to be less severe and less frequent. (See Prognosis.)

Before the development of chronic symptoms, many patients (42%) pass through a nonchronic stage, with attacks separated by intervals of complete remission.

The term pre-CPH stage or prechronic was preferred initially on the basis of the assumption that all patients would develop chronic symptoms. However, approximately 20% of patients appear to remain in the nonchronic stage for long periods.

ICHD-3 diagnostic criteria for CPH are as follows: [4]

A. Attacks fulfilling criteria for Paroxysmal hemicrania, and criterion B below

B. Occurring without a remission period, or with remissions lasting < 3 months, for at least 1 year

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