Hemicrania continua presenting as temporomandibular joint pain

Patients presenting with unilateral facial pain present a unique diagnostic challenge for dental practitioners. As dentists, we routinely look for maxillofacial pathology, temporomandibular disorders, or odontogenic abscesses as the etiology of pain in these patients. However, several types of the chronic daily headaches may also produce signs and symptoms similar to dental or maxillofacial pathology. One such headache, hemicrania continua, is typically characterized by a continuous, throbbing, unilateral headache and is completely responsive to treatment with indomethacin. In this article we present 2 cases in which initial symptoms suggested temporomandibular disorders but the patients were ultimately diagnosed with hemicrania continua. A brief review of hemicrania continua and its treatment is included. Thoroughly understanding this entity and realizing that it may present as temporomandibular pain will allow us to more readily diagnose the condition and implement effective treatment.