A child with hemicrania continua phenotype responsive to botulinum toxin type-A

Article type: Research Article

Authors: Prasad, Manish | Ramdas, Sithara | Abu-Arafeh, Ishaq

Affiliations: Department of Pediatric Neurology, Stirling Royal Infirmary, Stirling, UK

Note: [] Correspondence: Dr. Manish Prasad, Sheffield Children's Hospital, Western Bank, Sheffield, S10 2TH, UK. Tel.: +44 1142717000; Fax: +44 1142678296; E-mail: m.prasad@nhs.net

Abstract: Our aim is to describe the difficulties in the diagnosis and treatment of a child with continuous unilateral headache. We present the case of a 12-year-old child who had a two year history of continuous dull pain behind the right ear with frequent episodes of severe sharp pain as well as ipsilateral color change on the cheek. We assess the role of international classification of headache disorders in establishing the diagnosis and we assess the treatment options. The international classification of headache disorders criteria for the diagnosis of hemicrania continua are, based on experience with adults and may not be adequate in children. The child had a very poor quality of life due to his illness and failed to respond to indomethacin among many other medications. However, he responded well to treatment with botulinum toxin type-A on two occasions. Childhood hemicrania continua may have a different phenotype than that in adults. Botulinum toxin type-A may be an option for treatment in some patients.

Keywords: Botulinum toxin type-A (Botox), hemicrania continua, tension type headache, paroxysmal hemicrania continua

DOI: 10.3233/JPN-2012-0552

Journal: Journal of Pediatric Neurology, vol. 10, no. 2, pp. 155-159, 2012