3.4.1 Hemicrania continua, remitting subtype

A 36-year-old community pharmacist has had head pain that has persisted for about three months. She notes that carrying stock boxes at work or even brisk walking to the pharmacy reliably brings the pain on more strongly. She rates the pain as severe on a typical day, sharp enough that she has had to sit down mid-shift on several occasions, and it consistently stays on the same side of her head. She recalls that I arranged a trial of indomethacin through her GP, and she reports the pain lifted entirely once she reached the full dose, something she had not experienced in the preceding months. She is quick to point out that the pain was never a fixture even beforehand: she would typically have a clear run of just over a day, occasionally longer, completely free of pain before the next episode began. She denies visual symptoms, vomiting, or weakness in her arms or legs.