Abstract:
OBJECTIVE:We aimed to report 6 new cases of bifocal nummular headache (NH), showing their clinical characteristics and comparing them with those formerly described. BACKGROUND:NH is a focal head pain felt in a small, well-circumscribed, coin-shaped area. Among all the reported cases (over 200), 6 patients localized their pain in 2 or more separate areas. METHODS:We reviewed all patients diagnosed with NH at the headache clinics of 2 tertiary hospitals, searching for cases with head pain in 2 different areas. RESULTS:Six patients (4 female, 2 male; age at onset 40.8 ± 19.1, range 24-69 years) presented with bifocal NH. The shape and size of both painful areas were identical in each patient. They were located at symmetrical points of either side in 3 patients, while 2 patients had both symptomatic areas on the same side of the head. The chronological pattern was synchronous in 2 patients, and the other 4 showed an additive pattern with onset intervals between the 2 areas ranging from 2 months to 30 years. Pain intensity was slightly different in each area in 4 of the cases. Four patients were treated with a preventive (gabapentin or carbamazepine) with good clinical response. CONCLUSION:Although not frequently found, some patients may have bifocal or multifocal NH.
journal_name
Headachejournal_title
Headacheauthors
Guerrero AL,Cuadrado ML,García-García ME,Cortijo E,Herrero-Velázquez S,Rodríguez O,Mulero P,Porta-Etessam Jdoi
10.1111/j.1526-4610.2011.01940.xsubject
Has Abstractpub_date
2011-07-01 00:00:00pages
1161-6issue
7eissn
0017-8748issn
1526-4610journal_volume
51pub_type
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