Lunchtime headache
- Essex Centre for Neurology and Neurosurgery, Oldchurch Hospital, Romford, Essex RM7 0BE, UK
- Dr R de Silva
Chronic primary unilateral headaches fall into one of five categories: chronic cluster headache, chronic paroxysmal hemicrania, hemicrania continua, cervicogenic headache, and SUNCT syndrome. Overlap between types is recognised. Although the differentiation of these is sometimes difficult, there are important therapeutic implications—for example, indomethacin has a dramatic effect on chronic paroxysmal hemicrania but is less effective in chronic cluster headache. Here, a patient with paroxysmal unilateral headaches, occurring precisely on the same day of the week and at the same time, is described.
A 57 year old man presented with episodic, right sided, moderate to severe headaches of 9 months' duration. He developed these always on a Monday at 1300 hours. The headaches were sharp and throbbing with the maximum pain …
