Nummular Headache: Three New Cases

Abstract

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.

A new variant nummular headache: large diameter accompanied with bitrigeminal hyperalgesia and successful treatment with carbamazepine

“…The intensity of pain was severe, which was similar to the cases already reported (3,4,8,13,14,19,25,26), although it is worth noting that NH pain is typically described as mild to moderate (18,23). The majority of the pain quality of NH has been described as pressing, burning or dull (8,11,19,23,24,26,29,32). Lancinating pain attacks, without baseline pain, as the only manifestation (2 patients) have only previously been reported by Ruscheweyh et al (27); the present case brings this total to three.…”

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

“…However, it has been noted before that both baseline pain and exacerbations can be severe (1,3,6) and most cases of the paroxysmal form (without baseline pain) reported so far have been of severe intensity (11,12). In the present case series, all four patients suffering from electric-shock-like pain had severe pain.…”

Nummular headache

“…(Subjects included in the ICHD-2 appendix are entities deemed to be in need of additional study.) Since the 2004 publication, more than 30 additional cases have been reported in the English language literature [4][5][6][7][8][9].…”