How is chronic paroxysmal hemicrania (CPH) differentiated from other headaches with autonomic features?

Updated: Jun 12, 2019
  • Author: Monica Saini, MD, MBBS; more...
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Along with HC, several other paroxysmal, indomethacin-responsive headache syndromes have been described, including the following:

  • Jabs-and-jolts syndrome

  • Icepick headache

  • Hypnic headache syndrome

  • Benign cough headache syndrome

  • Benign exertional headache

  • Coital headache

  • Thunderclap headache

Cervicogenic headache, facial neuralgia, and other rare disorders, such as red ear syndrome, also are considered in the differential diagnosis.

Simultaneous occurrences of CPH and other disorders, including CH, trigeminal neuralgia (CPH-tic syndrome), and migraine, also have been reported. The crucial factor in the differential diagnosis is the absolute response to indomethacin.

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