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Chronic paroxysmal hemicrania was first described by Sjaastad and Dale in 1974.1 It is characterised by attacks of excruciating unilateral oculotemporal pain associated with autonomic changes, such as lacrimation, rhinorrhea, ptosis, miosis, and conjunctival suffusion. It differs from cluster headache for its female predominance, brevity (5–45 minutes), and frequency (5–20/day) of pain attacks, as well as for its response to indomethacin in doses of up to 150 mg/day.2 Experience with subcutaneous sumatriptan in chronic paroxysmal hemicrania is scarce. Here we report on the effect of subcutaneous sumatriptan in a patient with chronic paroxysmal hemicrania.
In May 1994, when 34 years old, this previously healthy woman started to have attacks of severe temporal and periorbital pain usually associated with conjunctival injection, lacrimation, ptosis, eyelid oedema, and nasal congestion. Frequency and duration of attacks were variable. She experienced at least five pain attacks a day …