Unmasking the Diagnosis: A Case of Hemicrania Continua

Hemicrania continua is a rare unilateral headache disorder characterized by autonomic symptoms and complete resolution when treated with indomethacin. We present a case of a woman with a continuous unilateral headache without autonomic features, who had been self-medicating with over-the-counter ibuprofen. After extensive evaluation, it was determined that ibuprofen had likely been masking the autonomic features of hemicrania continua. Upon discontinuation of ibuprofen and initiation of indomethacin, her symptoms resolved rapidly. This case highlights the potential for symptomatic medications to obscure diagnostic features, leading to delayed diagnosis and unnecessary testing.