What is the prognosis of chronic paroxysmal hemicrania (CPH)?

Updated: Jun 12, 2019
  • Author: Monica Saini, MD, MBBS; more...
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Patients in the nonremitting stage of CPH may need lifelong therapy, possibly with smaller doses of indomethacin.

Long-lasting remission periods usually reflect a nonchronic stage, but they may occur in patients with established chronic disease. In chronic cases, in fact, recurrence of attacks after a drug-free period of 1.5 years has been reported.

The mortality rate and morbidities associated with CPH have not been reported, although the therapy of choice for this condition, indomethacin, is known to be associated with the risk of bleeding.

Factors that may or may not affect the course of CPH include the following:

  • Pregnancy - CPH attacks have been reported to improve during pregnancy; however, they recur after delivery

  • Menstruation - Menstruation may have either a positive or negative effect on attacks

  • Birth control - Birth control pills do not seem to influence attack frequency

  • Menopause - Reliable data do not exist regarding the effects of menopause on CPH

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