Nummular Headache

Wilhour, Danielle; Ceriani, Claire E. J.; Nahas, Stephanie J.

doi:10.1007/s11910-019-0943-x

Cited by 14 publications

(17 citation statements)

References 62 publications

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“…Botox injections have also been successful in refractory headache. Spontaneous remission is also reported up to 40% of patients (2). The present case is the first to report the use of PENS in the management of nummular headaches.…”

Section: Discussionsupporting

confidence: 57%

“…In cases where an underlying cause for the nummular headache is found, for example, varicella zoster, scleroderma, or superficial aneurysm, good pain relief has been reported following treatment of this cause. Transcutaneous electrical nerve stimulation has also been reported to provide good pain relief although required constant stimulation (2). This case report is the first description of the management of a patient with nummular headaches using percutaneous electrical nerve stimulation (PENS).…”

Section: To the Editormentioning

confidence: 99%

“…This is based on the well-demarcated region of pain, associated sensory abnormalities and overlying trophic changes. A peripheral origin for the pain is challenged by the lack of improvement following local anesthetic nerve blocks; however, this could be explained by associated dysfunction of transdiploic or intradiploic nerves (2).…”

Section: To the Editormentioning

confidence: 99%

See 2 more Smart Citations

Nummular Headache Successfully Managed With Percutaneous Electrical Nerve Stimulation: A Case Report

Hall

Vajramani

2021

Neuromodulation: Technology at the Neural Interface

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Section: Discussionsupporting

confidence: 57%

Section: To the Editormentioning

confidence: 99%

See 1 more Smart Citation

Nummular Headache Successfully Managed With Percutaneous Electrical Nerve Stimulation: A Case Report

Hall

Vajramani

2021

Neuromodulation: Technology at the Neural Interface

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“…Preventive treatment is required in two third of patients. Gabapentin is the first line treatment, whereas use of many other prophylactics drugs has been described, with inconsistent results and no randomised controlled trials (RCT) to date (4,8,9).…”

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, previously also called coin-shaped headache is characterized by the continuous or intermittent headache of highly variable duration affecting a small, circumscribed, sharply contoured area of the scalp (fixed in size and shape, round or elliptical, 1–6 cm in diameter), usually affecting the parietal region. [ 1 ] Rarely, it may be multifocal; however, each area retains all the characteristic features of NH. Before establishing the diagnosis the physician needs to ensure that the headache is not better accounted for by any other diagnosis in ICHD 3 and physical examination and appropriate investigations have been performed to exclude underlying structural and dermatologic lesions.…”

mentioning

confidence: 99%