Numular headache: A coin-shaped cephalgia

Pareja, Juan A.; Caminero, Ana B.; Serra, J; Barriga, Francisco; Barón, Manuel González; Dobato, José Luis; Vela, Lydia; Río, Margarita Sánchez del

doi:10.1212/wnl.58.11.1678

Cited by 120 publications

(205 citation statements)

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“…Sir, Nummular headache (NH) is a chronic, mild-to-moderate head pain located in a small circumscribed area of the head in the absence of any lesion of cranial structures, first described by Pareja et al [1]. It was coded as A13.7.1 in the Appendix of the ICHD-II Classification [2].…”

mentioning

confidence: 99%

Nummular headache: another case treated with gabapentin

Trucco

2007

J Headache Pain

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mentioning

confidence: 99%

Nummular headache: another case treated with gabapentin

Trucco

2007

J Headache Pain

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“…Na série publicada por Pareja et al 1 , de treze casos cinco eram homens, cuja idade variou entre 26 e 66 anos (média de 50 anos ao iniciar quadro) e oito mulheres, com média de idade de 53 anos (33 e 70 anos). 70% de seus pacientes referiam dor localizada próxima à sutura parieto-occipital, sem predomínio nítido de lado.…”

Section: Discussionunclassified

Cefaléia numular: relato de caso

Monzillo

Neto

Sanvito

et al. 2004

Arq. Neuro-Psiquiatr.

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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 primárias ou relação temporal com trauma craniano. Apresentamos o primeiro caso em nosso país, com características clínicas superponíveis às da publicação de Pareja e col, com o intuito de chamar a atenção não só de especialistas em dor de cabeça, mas de neurologistas em geral, para esta forma não usual de cefaléia, bem como fazer considerações sobre o diagnóstico diferencial com esta entidade.PALAVRAS-CHAVE: cefaléia em moeda, cefaléia numular. Nummular headache: case reportABSTRACT -Nummular headache or coin shaped cephalalgia was first described by Pareja and coworkers in 2002. It seems to be a primary headache that has a chronic course, with a circumscribed area of pain described by the patients as elliptic or coin shaped. Patients experience periods without pain followed by bouts of daily headache. In the original series of thirteen cases it was sometimes associated with other primary headaches, but not necessarily. It could also be related to cranial trauma. We present the first case of of nummular headache described in our country with clinical features similar to the original series. We intend to alert neurologists and pain specialists to the existence of this unusual headache and also discuss the possible differential diagnosis of this cephalalgia.KEY WORDS: coin shaped headache, nummular headache.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.Apresentamos o primeiro caso observado em nosso país CASOMulher de 72 anos, do lar, natural de Portugal. Há cerca de sete anos queixa-se de cefaléia descrita como diária, contínua quando de baixa intensidade e assumindo característica latejante nos picos de maior intensidade. A graduação das crises numa escala analógica de zero a dez, está entre três e dez, atingindo o grau máximo de intensidade várias vezes ao dia, quando passa a ser muito incomodativa. Estas exacerbações chegam a durar horas. As crises nunca foram acompanhadas de náuseas, vômitos ou outros comemorativos de enxaqueca, tão pouco apresentando sinais de ativação autonômica. Os períodos com dor diária variam entre sete e dezoito dias, e se repetem por cerca de cinco vezes ao ano. No restante do tempo é assintomática. A dor, no seu pico mais forte, pode ser causa de int...

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“…This recently described headache [2] has an unusual, distinct feature: it is characterized by mild to moderate, pressure-like pain exclusively felt in a rounded or oval area typically 2-6 cm in diameter, without underlying structural lesions. The disorder tends to start from the forth decade of life, and it prevails in women.…”

Section: Nummular Headachementioning

confidence: 93%

“…Pain from cranial bone metastasis was noted as the prototype of this symptomatic focal headache. A primary circumscribed headache has recently been described as nummular headache (NH) [2]. It is characterized by mild to moderate, pressure-like, rather continuous pain, exclusively felt in a rounded or elliptical area typically 2-6 cm in diameter, and neither attributed to local lesion nor systemic disorder [2].…”

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confidence: 99%

Nummular headache, trochleitis, supraorbital neuralgia, and other epicranial headaches and neuralgias: the epicranias

Pareja

Pareja²,

2003

J Headache Pain

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Nummular headache is characterized by mild to moderate, pressure-like head pain exclusively in a small, rounded or oval area without underlying structural lesions. Either during symptomatic periods or interictally, the affected area shows a variable combination of hypoesthesia, dysesthesia, paresthesia, tenderness or discomfort. The particular topography and signs of sensory dysfunction suggest that nummular headache is an extracranial headache probably stemming from epicranial tissues such as the terminal branches of sensory nerves. Apart from nummular headache, other headaches and neuralgias such as idiopathic stabbing headache, trochleitis, supraorbital neuralgia, external compression headache, nasociliary neuralgia, occipital neuralgias, and auriculotemporal neuralgia have temporal or spatial features that suggest a peripheral (extracranial) origin, i. e. stemming from the bone, scalp, or pericranial nerves. Common to these disorders is a focal localization or a multidirectional sequence of paroxysms, paucity of accompaniments, tenderness on the emergence or course of a pericranial nerve or on the tissues where pain originates, and possible presence of symptoms and signs (including effective treatment with locally injected anesthetics or corticosteroids) of nerve dysfunction. These observations led to the emergence of a conceptual model of head pain with an epicranial origin that we propose to group under the appellation of epicranias (headaches and pericranial neuralgias stemming from epicranial tissues). Nummular headache is the paradigm of epicranias. Epicranias essentially differ from other primary headaches with an intracranial origin and features of visceral pain, i. e. splanchnocranias that are characterized by a painful area wider than that of epicranias, no clear borders, presence of autonomic features, regional muscle tension, and driving of the process from the brain and brainstem.

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Numular headache: A coin-shaped cephalgia

Abstract: Numular headache is a chronic, mild to moderate, pressurelike pain in a circumscribed cranial area of approximately 2 to 6 cm in diameter. Pain usually is limited to the parietal region, although it may appear in any cranial site. It is a benign process of usually unknown origin.

Cited by 120 publications

References 1 publication

Nummular headache: another case treated with gabapentin

Nummular headache: another case treated with gabapentin

Cefaléia numular: relato de caso

Nummular headache, trochleitis, supraorbital neuralgia, and other epicranial headaches and neuralgias: the epicranias

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