P047. Paroxysmal episodic hemicrania in a child. A complex differential diagnosis

Methods and results An 11-year-old boy referred to our Headache Centre suffering from headache for the past 5 years. Headache characteristics were: frontal pain, constricting in quality and excruciating pain intensity, at times vomiting. Duration of attacks was referred ranging from 20 to 40 minutes, headache occurred daily during the last 2 months. Attacks recurred many times daily. Attacks of headache occurred in periods lasting from 1 to 2 months, separated by pain-free periods lasting 1 month. During the headache attacks, the child presented eyelid oedema and nasal congestion. Personal medical history was negative. Familial history was positive for migraine without aura (paternal aunt). General and neurological examination, including fundus oculi, were normal. MRI scan resulted normal. Previous prophylaxis with pizotifen, amitriptyline, verapamil, topiramate and prednisone were ineffective, instead indomethacin was effective.