Case series of sixteen patients with nummular headache

Nummular headache is a rare primary headache disorder described by a focal circumscribed area of pain (2-6 cm in diameter). Literature on this disorder is sparse.

Here, we describe a case series of 16 patients (6 men, 10 women) seen at the Mayo Clinic.

Mean age of onset was 50 years (range, 19-79 years) and mean duration of headache was 7.9 years (range, 0.33-40 years). Location of headache varied and was found to be an average of 3.9 cm in diameter (range, 2-10 cm). Headache was episodic (< 15 days/month) in four patients and chronic (>15 days/month) in 12 patients. Attention was paid to therapeutic interventions. Resolution was seen in 38% of patients. Migraine was present in the history of 56% of patients and medication overuse headache was found in 25%.

Our series results support previous findings. In our population, no specific therapy was identified to be effective in more than one patient.