Benign cough headache is responsive to acetazolamide

Abstract

Benign cough headache (BCH) is a rare headache syndrome.1,2 It is defined by the International Headache Society (IHS) as a headache precipitated by coughing in the absence of any intracranial disorder. The headache is usually bilateral and of sudden onset, lasting less than 1 minute, and may be prevented by the avoidance of coughing.3 Most patients are responsive to indomethacin, although lumbar puncture has been advocated by Raskin.4 He suggested that both indomethacin and lumbar puncture were effective after a sudden decrease in intracranial pressure (ICP), and proposed that determination of the nature of the receptors that were sensitive to ICP alterations was probably the key to understanding this disorder.4 We conducted an open-label trial using acetazolamide in the treatment of BCH. The objectives were to provide an alternative treatment and to test the hypothesis that the efficacy of indomethacin and lumbar puncture results from the reduction of CSF volume. Five outpatients (four men, …