Successful Treatment of Nummular Headache With Tens

Nummular headache: Six new cases and lancinating pain attacks as possible manifestation

“…In our sample, treatment with amitriptyline or duloxetine was unsuccessful in two patients. New treatment options include local botulinum toxin that was successful in 7/9 cases in the literature (18,19) and one of our cases, and local transcutaneous electric nerve stimulation (one case) (20). It is not known if the pressing-continuous type of nummular headache requires different treatment from the paroxysmallancinating type, although under the assumption of neuropathic pain and led by the symptomatology, one might prefer gabapentin or pregabalin and antidepressants for chronic-continuous pain and oxcarbazepine and antidepressants for paroxysmallancinating pain (21).…”

Unusual Headache Syndromes

“…Gabapentin seems to be the most used preventive treatment for NH, although the results are inconsistent . Other treatments potentially helpful are naproxen, indomethacin, cyclobenzaprine, nortriptyline, carbamazepine, lamotrigine, neurotropin®, and transcutaneous electrical nerve stimulation …”

Can Temporal Course of Pain Determine Patient Response to Specific Medication in Nummular Headache?

“…Studies thus far have identified response among patients to treatment with NSAIDS – including indomethacin7‐9 – as well as with gabapentin,6,10‐12 botulinum toxin, carbamazepine, tricyclic antidepressants, and neurotropin . Recent studies utilizing transcutaneous electrical nerve stimulation have also been reported to be effective . Of all these, gabapentin has been the most widely utilized, although none have yet been identified as achieving complete resolution of the headaches.…”