Epicrania fugax originating from a surgical scar of the scalp

Cuadrado, María‐Luz; González‐García, Nuria; Porta‐Etessam, J.

doi:10.1111/papr.13109

Cited by 1 publication

(7 citation statements)

References 12 publications

(17 reference statements)

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“…This hypothesis would justify the fact that the painful paroxysms start in a focal area. It would also be in line with the frequent coexistence of NH at this stemming point (29,36,71–76). Furthermore, this hypothesis would be supported by one of the reported cases of secondary EF, where the symptoms could be related to the development of a keloid scar after local scalp surgery (76).…”

Section: Epicrania Fugaxsupporting

confidence: 69%

“…As noted above, between the paroxysms of EF some patients present with a circumscribed headache, which remains restricted to a small coin-shaped area, and which according to ICHD-3 criteria would correspond to NH (29,36,71–76). In all published cases the area of NH was located at the point of origin of EF, so we could hypothesize that there may be a pathogenic connection between the two entities.…”

Section: Epicrania Fugaxmentioning

confidence: 89%

“…At times NH coexists with epicrania fugax (EF), and in these cases there does appear to be a connection. As will be discussed below, a coin-shaped pain with features of NH may sometimes persist at the point of origin of EF paroxysms (29,36,(71)(72)(73)(74)(75)(76).…”

Section: Association With Other Headachesmentioning

confidence: 99%

“…EF is, in principle, a primary headache, and its diagnosis requires the exclusion of any underlying disorder (76,(124)(125)(126). Assessment of the patient should include careful inspection, palpation, and sensitivity testing of the area where the pain arises; this area may remain tender between attacks but should not show signs of another disease.…”

Section: Diagnosismentioning

confidence: 99%

“…However, there are also patients in whom a single oral drug has been useful in controlling both types of pain (36). In addition, cases have been reported in which OnabotA injections at the NH site suppressed both local NH pain and radiating EF pain (75,76).…”

Section: Treatmentmentioning

confidence: 99%

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Epicranial headaches part 2: Nummular headache and epicrania fugax

Cuadrado

2023

Cephalalgia

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Background Nummular headache and epicrania fugax are two primary headaches that fall under the heading of epicranial headaches. Methods This article reviews the epidemiological and clinical features of nummular headache and epicrania fugax, proposed pathogenic mechanisms and state-of-the-art management, according to the literature. Results and conclusions Nummular headache and epicrania fugax are generally viewed as rare headache disorders, but no population-based epidemiological data are available. Nummular headache is characterized by continuous or intermittent head pain, which remains circumscribed in a round or oval area of the scalp, typically one to six centimeters in diameter. Epicrania fugax manifests with brief paroxysms of pain that move along the surface of the head, following a linear or zigzag trajectory through different nerve territories. Nummular headache and epicrania fugax are mostly primary headaches, but some secondary cases have been reported. The pathogenesis of these headaches is not fully understood. Nummular headache could probably originate in epicranial tissues or adjacent intracranial structures, while the origin of epicrania fugax could be extracranial or intracranial. Diagnostic assessment requires careful examination of the symptomatic areas. Underlying disorders should be excluded by additional investigations, including neuroimaging and appropriate blood tests. No controlled clinical trials have been conducted in nummular headache or epicrania fugax. Analgesics and anti-inflammatory drugs, botulinum toxin and gabapentin are currently the most recommended treatment options for nummular headache. In epicrania fugax, the most used treatments are gabapentin, lamotrigine, and other antiseizure medications.

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