chronic paroxysmal hemicrania is a severe debilitating unilateral headache meaning it affects only half of the head commonly localized around the eyes it is more commonly diagnosed in women than in men occurs at any age but common after 30. migraine also may be associated with pain and half of the head but it is different from chronic paroxysmal hemicrania chronic paroxysmal hemicrania has no neurological symptoms associated with it individuals with chronic paroxysmal hemicrania suffer multiple short severe headaches a day often more than five with most lasting between 5 and 30 minutes each after attack period comes remission symptoms free days or weeks chronic paroxysmal hemicrania is a long-term disease with symptoms lasting for longer than a year causes many secondary conditions can be possible causes of chronic paroxysmal hemicrania such aneurysms in the circle of willis middle cerebral artery infarction parietal arteriovenous malformation malignant frontal tumors and other pathological conditions that's why it's important to investigate further underlying condition during paroxysmal hemicrania important urgency mri scan of the head the difference between cluster headache and chronic paroxysmal hemicrania chronic paroxysmal hemicrania is more common in women than men with the opposite occurring with cluster headaches cph attacks occur more frequently but are shorter cph effects all over the head cluster headache is more localized treatment chronic paroxysmal hemicrania is well managed with endomethicin 25 milligrams per day 150 milligrams per day with a median dose of 75 milligrams per 24-hour period use of tapiramate has also been found to be an effective treatment for chronic paroxysmal hemicrania prevalence of chronic paroxysmal hemicrania is 1 in 50 000 people while cluster headache prevalence is 1 in 1 000 people