Suna SARIKAYA, Murat YILMAZ, Fatma AFANDİZADE, Tahir YOLDAŞ, Bülent GÜVEN

İki Farklı hemikranya kontinu vakası sunumu

Hemikranya kontinu (HK), şiddeti değişebilen, ancak artıp azalsa da tam olarak geçmeyen, sürekli tek tarafı ağrı ilekarakterize, görece nadir görülen, indometazine cevaplı bir primer baş ağrısı sendromudur. Sürekli olarak bulunanyarım baş ağrısının üzerine arada daha şiddetli alevlenmeler eklenir. Bu şiddetli alevlenmelere sıklıkla pitoz, miyozis,göz yaşarması ve terleme gibi otonom bozukluklar eşlik eder (1). Hastalarda fotofobi, fonofobi, bulantı olabilir. Te- davisinde indometazin verilir, ancak indometazini tolere edemeyen ya da cevapsız olgulara parasetamol, ibuprofen,tramadol, amitriptilin, propranolol, gabapentin, metilprednizolon ve oksipital sinire lidokain enjeksiyonu gibi alter- natif tedaviler de denenmektedir. Bu yazımızda HK tanı kriterlerini karşılayan, öykü ve klinik özellikleri birbirineoldukça benzeyen ancak indometazine tedavi yanıtları tamamen farklı olan iki vakayı sunduk.

Two cases report of hemicrania continua

Hemicrania continua (HC) is a rare primary headache syndrome characterized by, severity vary, in- creasing and reducing period but not completely improved, continuous one- side pain, relatively rare and respon- sive to indomethacin. Continuous one-side headache, more severe exacerbations are added together. This oftensevere exacerbations are accompanied autonomic disturbances such as ptosis, miosis, tearing and sweating(1). Pa- tients may have photophobia, fonophobia and nausea. Indomethacin is used for treatment but intolerance or unre- sponsive cases are used alternative treatments such as paracetamol, ibuprofen, tramadol, amitriptyline, propranolol,gabapentin, methylprednisolone and lidocaine injection of occipital nerve. In this case article full-flled diagnosticcriteria for HC but completely different responses to indomethacin treatment, two cases are reported.

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