Atypical Nummular Headache or Circumscribed Migraine: The Utility of Pressure Algometry

Barón, Johanna; Rodríguez, C. de la Cruz; Ruíz, Magdalena; Pedraza, M.I.; Peral, Á.L. Guerrero; Madeleine, Pascal; Cuadrado, María‐Luz; Fernández‐de‐las‐Peñas, César

doi:10.1155/2015/567072

Cited by 16 publications

(16 citation statements)

References 13 publications

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“… 11 In the case described, the effectiveness of PEA as a prophylactic therapy for NH is clear, as demonstrated by the improvement in rates of pain measuring scales, with excellent clinical response, as evidenced also by the gradual improvement in pain symptoms, despite the reduction of topiramate. 12 No adverse effects related to the drugs administered were reported during the observational periods, but a case series or clinical trial is necessary for the future.…”

Section: Discussionmentioning

confidence: 99%

Administration of palmitoylethanolamide in combination with topiramate in the preventive treatment of nummular headache

Chirchiglia¹,

Torre²,

Signorelli³

et al. 2016

IMCRJ

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Nummular headache has been recently described as a primary disorder characterized by head pain exclusively felt in a small rounded area typically 2–6 cm in diameter, not attributed to another disorder. Both size and shape of the painful area remain constant since the onset of symptoms. A 57-year-old woman presented with a history of focal episodic pain in a circumscribed area on the right parietal region. The administration of standard oral doses of palmitoylethanolamide and topiramate in combination showed an improvement in pain symptoms and on pain measuring scales.

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Section: Discussionmentioning

confidence: 99%

Administration of palmitoylethanolamide in combination with topiramate in the preventive treatment of nummular headache

Chirchiglia¹,

Torre²,

Signorelli³

et al. 2016

IMCRJ

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“…It is characterised by superficial pain, sharply contoured, with a fixed round or elliptical shape and size, which can range from 1–6 cm (2–3). Its pathophysiology suggested impairment of superficial sensory terminations, considering its superficial topography, precise location, and the frequent presence of circumscribed allodynia and trophic changes as a marker of superficial sensory fiber dysfunction (4–7). Preventive treatment is required in two third of patients.…”

Section: Introductionmentioning

confidence: 99%

Observational, open-label, non-randomized study on the efficacy of onabotulinumtoxinA in the treatment of nummular headache: The pre-numabot study

et al. 2019

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Background Nummular headache is a primary headache characterised by superficial, coin-shaped pain. Superficial sensory fibre dysfunction might be involved in its pathophysiology. Considering the mechanism of action of onabotulinumtoxinA, it could be a reasonable option in treatment of nummular headache. The aim of the study was to evaluate the efficacy and tolerability of onabotulinumtoxinA in a series of nummular headache patients. Patients and methods This was an observational, prospective, non-randomized and open-label study. Nummular headache patients with at least 10 headache days in three preceding months were included. They were administered 25 units of onabotulinumtoxinA. The primary endpoint was the decrease of headache days per month, evaluated between weeks 20 to 24, compared with baseline. The secondary endpoints included reduction of intense headache days and acute treatment days evaluated between weeks 20–24 and weeks 8–12, compared with baseline. The 30%, 50% and 75% responder rates were determined, and tolerability described. Results We included 53 patients, 67.9% females, with a median age of 54 years. Preventive treatment had been used previously in 60.4% of patients. The median diameter of the nummular headache was 5 cm. At baseline, the number of headache days per month was 24.5 (7.3); the number of intense headache days was 12.5 (10.1), and the number of acute treatment days was 12.8 (7.8). After onabotulinumtoxinA, the mean number of headache days per month decreased to 6.9 (9.3) between weeks 20 and 24 ( p < 0.001). Secondary endpoints concerning intense headache days per month and acute treatment days per month were also statistically significant ( p < 0.001). The 50% responder rate, evaluated between weeks 20 and 24, was 77.4% and the 75% responder rate was 52.8%. Concerning tolerability, 26 patients (49.1%) experienced an adverse event (AE), the commonest being injection-site pain in 12 cases (22.6%). There were no moderate or severe AEs. Conclusion It was found that after injecting onabotulinumtoxinA, the number of headache days per month was reduced in nummular headache patients. The number of intense headache days per month and acute treatment days were also lowered. No serious adverse events occurred during treatment.

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“…NH is a continuous or intermittent pain which is commonly oppressive head pain circumscribed within a rounded or elliptical area, typically 1–6 cm in diameter (Pareja et al 2002 ; IHS 2013 ). But, NH may present atypical features resembling a migraine pattern such as paroxymal episodes, accompaniments of nausea, photophobia and phonophobia (Dai et al 2013 ), triggering or aggravating factor of physical exercise (Mulero et al 2013 ; Baron et al 2015 ), or relation to menstruation (Robbins and Grosberg 2010 ). Our patient also showed pain features resembling a migraine pattern of episodic pain accompanied with dizziness, head heaviness, photophobia and phonophobia, triggered by anxiety or dysphoria.…”

Section: Discussion and Evaluationmentioning

confidence: 99%

A recurrent headache circumscribed in a coronal line-shaped area around the head: a coronal linear headache

Wang

Pan

et al. 2016

SpringerPlus

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BackgroundLinear headache (LH) has recently been described as a paroxysmal or continuous head pain restricted in a linear trajectory of 5–10 mm in width, linking one endpoint in occipital or occipitocervical region with another endpoint in ipsilateral nasion or forehead region. The sagittal line-shaped pain area of LH is close and parallel to a sagittal venous sinus, the superior sagittal sinus (SSS). For some patients, the LH had some features resembling the pattern of migraine without aura.Case descriptionA 45 year-old woman complained with a distinct headache for more than half years. The pain trajectory of the headache is confined to a coronal line-shaped area of 5–10 mm in width linking the two points in the bilateral temporal regions with the occipital protuberance. This coronal line-shaped pain area is close and parallel to a coronal cambered venous sinus complex, the combination of the confluences of sinus and the bilateral cavernous sinus (CS), superior petrosal sinus (SPS) linking the CS with transverse sinus (TS) and TS into which the SPS feeds. The patient had a past history of migraine without aura for 10 years and her son had a benign paroxysmal vertigo (BPV) for 12 years. Both of her coronal line-shaped headache and her son’s vertigo had well response to sodium valproate.Discussion and evaluationIts clinical characteristics were distinctly different from those of other two headache entities defined with topographical criteria, nummular headache and epicrania fugax, and different from other existing headache entities except for migraine without aura.ConclusionThe distinct coronal line-shaped headache is suggestive of a variant of LH, a coronal LH, and probably belongs to a subtype of migraine without aura as proposed for LH. This coronal LH reinforces the proposal of LH as a new headache syndrome or a subtype of a previously known headache syndrome, probably of migraine.

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Atypical Nummular Headache or Circumscribed Migraine: The Utility of Pressure Algometry

Cited by 16 publications

References 13 publications

Administration of palmitoylethanolamide in combination with topiramate in the preventive treatment of nummular headache

Administration of palmitoylethanolamide in combination with topiramate in the preventive treatment of nummular headache

Observational, open-label, non-randomized study on the efficacy of onabotulinumtoxinA in the treatment of nummular headache: The pre-numabot study

A recurrent headache circumscribed in a coronal line-shaped area around the head: a coronal linear headache

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