Nummular headache: a gender-oriented perspective on a case series from the RegistRare Network
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ORIGINAL ARTICLE
Nummular headache: a gender-oriented perspective on a case series from the RegistRare Network Lanfranco Pellesi 1 & Sabina Cevoli 2 & Valentina Favoni 2,3 & Chiara Lupi 4 & Edoardo Mampreso 5 & Andrea Negro 6 & Antonio Russo 7 & Silvia Benemei 4 & Simona Guerzoni 1 Received: 19 July 2019 / Accepted: 26 October 2019 # Fondazione Società Italiana di Neurologia 2019
Abstract Background Nummular headache (NH) is a rare headache disorder characterized by a small, circumscribed painful area of the scalp. The description of many cases in the last years has supported its re-classification as a primary headache from the International Headache Society, moving it from its previous placement in the Appendix of the International Criteria of Headache Disorders. Methods Data were collected from a retro-prospective observational study about rare headaches promoted by the RegistRare Network, a collaborative group of seven Italian Headache Centres. According to the gender-biased profile of certain primary headaches, we have looked further NH patients from a gender perspective. Results Nineteen NH patients (11 men, 8 women) have been enrolled in the study. Headache onset was at 39 years and preceded approximately 8 years the diagnosis. No clinically evident differences between men and women have been found, including treatment prescriptions and headache resolution. Of note, the mean time from the onset of NH to the first visit in a Headache Centre was longer in men, compared with women (13.5 vs. 0.9 years). NH attacks were efficaciously treated with nonsteroidal anti-inflammatory drugs in 60% of patients receiving treatment. Headache prophylaxis with pregabalin and amitriptyline has been reported as effective in 40% and 67% of the treated patients, respectively. Conclusions NH is a primary headache clinically heterogeneous in terms of temporal patterns and pain characteristics. Further research is needed to investigate the existence of male and female phenotypes, by clarifying whether it may be relevant for therapeutic purposes. Keywords Nummular headache . Gender . RegistRare Network . Primary headaches
Background Nummular headache (NH) is a rare headache [1], with pain in a small and rounded area on the head. NH often appears in the
fourth decade of life commonly as a primary disorder, but secondary forms have also been reported [2]. One painful area is the standard, often clearly side-locked. According to the first thirteen cases described in 2002, the area is round or oval,
Silvia Benemei and Simona Guerzoni contributed equally to this work. * Lanfranco Pellesi
1
Medical Toxicology, Headache and Drug Abuse Centre, University of Modena e Reggio Emilia, Modena, Italy
2
IRCCS, Institute of Neurological Sciences of Bologna, Bologna, Italy
3
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
4
Headache Centre, Careggi University Hospital, Department of Health Sciences, University of Florence, Florence, Italy
5
Headache Centre, Neurology - Euganea, Padua Health Unit,
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