Abstract:RESUMO -A cefaléia numular (CN) ou cefaléia em forma de moeda (coin-shaped headache) foi descrita pela primeira vez por Pareja e colaboradores em 2002. É uma cefaléia de curso crônico, aparentemente primária, sendo a dor restrita a uma área circunscrita do crânio, cuja forma pode ser elíptica ou em moeda. Evolui ao longo do tempo com períodos de dor, intercalados por períodos assintomáticos. Na série de treze casos apresentada por esses autores ou não ocorreu concomitância com outras formas de cefaléias primár… Show more
“…In a follow-up study (6), paracetamol has been shown to be beneficial as acute treatment. Gabapentin was an effective preventive therapy in two case reports (7, 8) and a case of NH was absolutely responsive to naproxen (9).…”
Nummular headache is proposed as a distinct type of headache in the Appendix of the second edition of the International Classification of Headache Disorders (ICHD-II). It is a chronic condition, with the following characteristics: pain is felt on a small circumscribed cranial area; pain is of mild to moderate intensity; there is no evidence of a structural abnormality. Herein, three cases fulfilling the ICHD-II proposed criteria (code A13.7.1) for nummular headache are reported.
“…In a follow-up study (6), paracetamol has been shown to be beneficial as acute treatment. Gabapentin was an effective preventive therapy in two case reports (7, 8) and a case of NH was absolutely responsive to naproxen (9).…”
Nummular headache is proposed as a distinct type of headache in the Appendix of the second edition of the International Classification of Headache Disorders (ICHD-II). It is a chronic condition, with the following characteristics: pain is felt on a small circumscribed cranial area; pain is of mild to moderate intensity; there is no evidence of a structural abnormality. Herein, three cases fulfilling the ICHD-II proposed criteria (code A13.7.1) for nummular headache are reported.
“…In NH patients with mild pain or only discomfort, treatment was either needless or analgesics and nonsteroidal antiinflammatory drugs usually sufficed. This seems to be also the experience of Monzillo et al, who described an NH case absolutely responsive to standard oral doses of naproxen 2 . However, patients suffering from moderate or even severe pain, required prophylactic treatment—including antimigrainous, antidepressant, and antiepileptic drugs—that proved to be generally unsatisfactory, except for isolated cases 3 .…”
“…Since the original description in 2002 (1), reports of multiple cases have increased our clinical knowledge on NH (3–27). For example, we now know that the pain may be severe (3, 5, 13, 14, 17, 20, 24, 25), although it is usually mild or moderate.…”
Section: Discussionmentioning
confidence: 99%
“…Furthermore, there could be a variable combination of sensory disturbances within the symptomatic area, including hypoaesthesia, paraesthesia, dysaesthesia and tenderness. However, since the first description of 13 patients in 2002, > 100 additional cases have been reported (3–27), some of which have shown different features, thus expanding the clinical spectrum of NH. Here we describe a new clinical feature in three patients, each presenting with focal head pain in two separate areas.…”
Nummular headache (NH) has been defined as a focal head pain that is exclusively felt in a small area of the head surface. Here we describe three patients who presented with focal head pain in two separate areas. This finding seems to be consistent with bifocal NH and further enlarges the clinical diversity of this headache disorder. The pathogenic mechanisms of NH may be active in multiple cranial areas in some particular patients.
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