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$Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain$

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Nummular headache with trophic changes inside the painful area.

J A Pareja¹, M L Cuadrado, C Fernández-de-las Peñas

¹Department of Neurology, Fundación Hospital Alcorcón, Alcorcón, Madrid, Spain. japareja@fhalcorcon.es

Cephalalgia : an International Journal of Headache

|January 17, 2008

Summary

Nummular headache (NH) patients may develop localized skin changes like depressions and hair loss. These trophic alterations, alongside pain, suggest a potential evolution of NH, possibly resembling complex regional pain syndrome.

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Area of Science:

Neurology
Dermatology

Background:

Nummular headache (NH) is a primary headache disorder defined by localized head pain.
NH is characterized by chronic pain exclusively in a small area of the head surface.

Observation:

Five patients with NH presented with circumscribed head pain and sensory dysfunction.
These patients also developed colocalized trophic skin changes within the painful area.
Observed changes included skin depression, hair loss, redness, and increased local temperature.

Findings:

Skin biopsies in three patients were non-specific for any particular dermatological disease.
Local trophic changes appear to be a potential clinical feature of nummular headache.
The combination of pain, sensory disturbances, and trophic changes is noted.

Implications:

These findings suggest that trophic changes may represent a restricted form of complex regional pain syndrome associated with NH.
This could indicate a possible evolution of the underlying pathological process in nummular headache.
Further research is warranted to understand the link between NH and these observed trophic alterations.