Cyclic remissions in chronic paroxysmal hemicrania (CPH) have been considered to be transitory phenomena inevitably leading to the chronic stage. This conclusion has precluded the possibility of paroxysmal hemicrania having an episodic counterpart. Six case histories presented here establish the persistence of cyclic patterns for a mean of 23 years of illness, thus suggesting that the “pre-CPH” nomenclature may be presumptive, and, further, provide evidence for another classification: episodic paroxysmal hemicrania.
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