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Bifocal Nummular Headache: A Series of 6 New Cases
Author(s) -
Guerrero Ángel L.,
Cuadrado María L.,
GarcíaGarcía María E.,
Cortijo Elisa,
HerreroVelázquez Sonia,
Rodríguez Octavio,
Mulero Patricia,
PortaEtessam Jesús
Publication year - 2011
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2011.01940.x
Subject(s) - medicine , carbamazepine , gabapentin , dermatology , pediatrics , surgery , epilepsy , pathology , alternative medicine , psychiatry
( Headache 2011;51:1161‐1166) 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.