Simultaneous occurrence of ipsilateral cluster headache and chronic paroxysmal hemicrania: A case report

A 42-year-old man came to our headache unit in October 1995 complaining of recurrent attacks of headache, which had begun in February 1991, Chronic cl uster headache was diagnosed, and he was given verapamil, 360 mg per day. T he attacks ceased in the following months and verapamil was stopped in Marc h 1996, In May 1997, a recurrence of the attacks required the readministrat ion of verapamil, 360 mg per day, The attacks decreased tone to three per w eek), but after 2 months the patient reported a worsening in his condition due to the appearance of shorter attacks, which were diagnosed as chronic p aroxysmal hemicrania, The administration of indomethacin, 225 mg per day, r esulted in the disappearance of the short attacks. The concomitant occurrence of attacks of cluster headache and chronic parox ysmal hemicrania suggests the presence of shared factors in the pathophysio logy of the two forms of headache. This hypothesis Is supported by previous reports in the literature.