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Nummular headache: an update and future prospects.

María Luz Cuadrado1,2, Pedro López-Ruiz3, Ángel L Guerrero4,5

  • 1a Department of Neurology, Instituto de Investigación Sanitaria San Carlos (IdISSC) , Hospital Clínico San Carlos , Madrid , Spain.

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|November 7, 2017
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Summary
This summary is machine-generated.

Nummular headache (NH) causes localized scalp pain. Gabapentin and onabotulinum toxin type A show promise for managing this common headache disorder.

Keywords:
Epicranial headachegabapentinheadachenummular headacheonabotulinum toxin type Aprimary headache

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Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Nummular headache (NH) presents as localized, round or oval scalp pain, typically 1-6 cm in diameter.
  • Pain intensity varies from mild to severe, impacting quality of life for some patients.
  • NH is common in headache clinic attendees, though true incidence and prevalence data are limited.

Purpose of the Study:

  • To review the epidemiological and clinical features of nummular headache.
  • To discuss proposed pathophysiological mechanisms.
  • To outline current management strategies based on available literature.

Main Methods:

  • Literature review of epidemiological, clinical, and management aspects of NH.
  • Analysis of diagnostic work-up procedures.
  • Evaluation of treatment efficacy based on existing evidence.

Main Results:

  • Diagnostic work-up involves excluding other conditions via physical examination, blood tests, and neuroimaging.
  • No clinical trials exist for NH, resulting in low evidence levels for treatments.
  • Gabapentin is identified as a potentially effective oral treatment.
  • Subcutaneous onabotulinum toxin type A injections are also considered effective.

Conclusions:

  • Nummular headache requires a thorough diagnostic process to rule out other diseases.
  • Evidence for NH treatments is limited, necessitating further research.
  • Gabapentin and onabotulinum toxin type A are current therapeutic options for nummular headache management.