Paroxysmal hemicrania is treated with oral preventive therapy to prevent exacerbations. Evidence-based first-line options are available for both adult and paediatric patients.
Oral preventive agents are used as first-line management — agents with an established role in migraine prophylaxis, such as topiramate, have also been studied for paroxysmal hemicrania with meaningful results. Additional options and the complete clinical algorithm are in the full protocol.
DOI: 10.1186/s10194-017-0777-3
Since the hypothesized overlapping between PH and migraine pathogenesis, two well-known migraine prophylaxis such as topiramate and amitriptyline have been tried for PH, with comparable and moderate results.
Topiramate and amitriptyline are also comparable to piroxicam and verapamil in terms of effectiveness, even though the latter shows a not-significant higher odds of responders and complete responders.
View source ↗