Chronic Paroxysmal Hemicrania Presenting as Toothache

Chronic paroxysmal hemicrania is an intermittent head-pain problem that is characterized by pain paroxysms lasting about 15 minutes. The attacks usually produce pain in the frontotemporal region and are responsive to indomethacin. A set of symptoms that defines chronic paroxysmal hemicrania is presented, and two cases in which the presenting symptom was toothache are reported. It is emphasized that clinicians should consider chronic paroxysmal hemicrania in the differential diagnosis of orofacial pain.