Nummular headache: diagnosis and treatment

Area of Science:

• Neurology
• Pain Medicine
• Headache Disorders

Background:

• Nummular headache is defined by distinct coin-shaped head pain.
• It presents as mild-to-moderate pressure-like pain in a localized, rounded or elliptical area (2-6 cm).
• The parietal area is a common site, with pain confined to a stable symptomatic region.

Purpose of the Study:

• To describe the clinical characteristics of nummular headache.
• To differentiate nummular headache from other headache types and secondary head pains.
• To propose a potential pathophysiology and classification for nummular headache.

Main Methods:

• Clinical description and characterization of nummular headache.
• Review of diagnostic criteria and differential diagnoses.
• Discussion of potential origins and classification within headache disorders.

Main Results:

• Nummular headache is a primary headache with continuous pain, sometimes with exacerbations.
• Associated sensory disturbances like hypoesthesia or tenderness may occur in the affected area.
• Physical and supplementary examinations are typically normal, supporting its classification as a primary headache.

Conclusions:

• Nummular headache is a distinct primary headache, likely originating from epicranial tissues.
• It should be differentiated from secondary head pains and tender points of other headaches.
• Treatment is rarely needed, with reassurance often being sufficient.