Chronic paroxysmal hemicrania, intractable
ICD-10 G44.041 is a billable code used to indicate a diagnosis of chronic paroxysmal hemicrania, intractable.
Chronic paroxysmal hemicrania (CPH) is a rare primary headache disorder characterized by recurrent, unilateral headaches that occur in clusters. The headaches are typically short-lived, lasting from 2 to 30 minutes, but can occur multiple times a day. Intractable CPH refers to cases where the headaches are resistant to standard treatments, leading to significant disability and a reduced quality of life. Patients often experience severe pain, which can be accompanied by autonomic symptoms such as lacrimation, nasal congestion, and ptosis. The exact etiology of CPH remains unclear, but it is thought to involve dysfunction in the trigeminal autonomic reflex. Triggers may include alcohol consumption, certain foods, and changes in sleep patterns. Preventive treatments often include indomethacin, which is considered the first-line therapy, along with other options such as verapamil or corticosteroids for patients who do not respond to indomethacin. Accurate diagnosis and management are crucial for improving patient outcomes.
Detailed headache diaries, treatment history, and response to medications.
Patients presenting with recurrent unilateral headaches, especially those unresponsive to standard treatments.
Neurologists should ensure comprehensive evaluations to rule out secondary causes of headaches.
Assessment of pain levels, functional impact, and response to interventional therapies.
Patients seeking relief from chronic headache pain, particularly those with intractable symptoms.
Pain management specialists may need to document multidisciplinary approaches to treatment.
Used for follow-up visits for chronic headache management.
Document history, examination findings, and treatment plan.
Neurologists should include detailed headache diaries.
Chronic paroxysmal hemicrania is characterized by short, severe unilateral headaches that occur in clusters, often with autonomic symptoms, and is typically responsive to indomethacin, unlike migraines or tension-type headaches.
