[Nummular headache: case report].

Irmandade da Santa Casa de Misericórdia de São Paulo, Brazil.
Arquivos de Neuro-Psiquiatria (Impact Factor: 1.01). 10/2004; 62(3B):903-5.
Source: PubMed

ABSTRACT 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.

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    ABSTRACT: Münzkopfschmerz („nummular headache“) bezeichnet einen neu definierten, eng umschriebenen, in Attacken auftretenden Kopfschmerz in einem münzgroßen Areal. Bislang wird die Erkrankung im Anhang der Klassifikation der International Headache Society (ICHD-II) geführt, da die Abgrenzung als eigenständiges Erkrankungsbild noch in der Diskussion ist. Über die Epidemiologie dieses seltenen primären Kopfschmerzes ist nichts bekannt. Wir berichten über eine 65-jährige Patientin, die auf eine Therapie mit Clomipramin ansprach, und einen 45-jährigen Mann, der von progressiver Muskelrelaxation profitierte. The term nummular (coin-like) headache describes a newly defined localized headache. The epidemiology of this rare primary headache type is unknown. Until now nummular headache has been classified in the appendix of the IHS headache classification because of ongoing discussion about the etiology. We report a 65-year-old woman who was successfully treated with clomipramine and a 45-year-old man with improvement through relaxation therapy.
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    ABSTRACT: Nummular headache is characterized by head pain exclusively felt in a rounded or elliptical area, typically 1 to 6 cm in diameter. The pain remains confined to the same symptomatic area, which does not change in shape or size with time. The symptomatic area may be localized in any part of the head but mostly in the parietal region. Rarely, the disorder may be multifocal, each symptomatic area keeping all the characteristics of nummular headache. The pain is generally mild or moderate, commonly described as oppressive or stabbing, and lasting minutes, hours, or days, with a remitting or unremitting pattern. Superimposed on the baseline pain, there may be spontaneous or triggered exacerbations. During and between symptomatic periods, the affected area may show variable combinations of hypoesthesia, dysesthesia, paresthesia, tenderness, and trophic changes. Nummular headache emerges as a primary disorder with a clear-cut clinical picture developed in a unique topography.
    Current Neurology and Neuroscience Reports 12/2011; 12(2):118-24. DOI:10.1007/s11910-011-0247-2 · 3.78 Impact Factor

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