title: [Nummular headache: clinical features and therapeutic experience in a series of 30 new cases].
abstract: BACKGROUND
  Nummular headache (NH) is a mild or moderate pain, located in a small, well circumscribed, rounded or elliptical area. Temporal pattern is variable and pain exacerbations have been described. AIM. To analyze clinical characteristics and therapy requirement and response in a series of patients attended due to NH in a headache outpatient office.
  
  
  METHODS
  30 patients (18 females, 12 males) diagnosed as NH. We considered demographic and nosological characteristics, temporal pattern, presence and intensity of exacerbations, and requirement of symptomatic or preventive therapies.
  
  
  RESULTS
  Age at onset 49.2 ± 18.1 years (range: 21-79 years). Two of the patients presented a bifocal NH and we analyzed 32 areas, 28 rounded and 4 elliptical. Diameter: 4.7 ± 1.1 cm. Regarding locations occipital (10 areas, 31.3%), parietal (9 areas, 28.1%) and frontal (6 areas, 18.8%). Pain intensity of 5.2 ± 1.8 on a ten-point visual analogical scale. Regarding temporal profile, in 18 areas (56.3%) was chronic, in 5 (15.6%) episodic and undefined due to a scarce time from onset in 9 (28.1%). In 16 areas (50%) pain exacerbations lasting from 3 seconds to 15 minutes occurred. Nine (30%) patients did not improve with symptomatic drugs, and at least one preventative was prescribed in 23 (76.6%) patients without consistent effectiveness.
  
  
  CONCLUSIONS
  NH is not an uncommon diagnosis in an outpatient headache office. In our series, basal pain intensity is moderate and symptomatic drugs commonly provide no relief. So, patients frequently need a preventive therapy.
authors.affiliation: Hospital Clinico Universitario de Valladolid, 47005 Valladolid, Espana.
authors.forename: E
authors.initials: E
authors.lastname: Cortijo
authors.forename: A L
authors.initials: AL
authors.lastname: Guerrero-Peral
authors.forename: S
authors.initials: S
authors.lastname: Herrero-Velazquez
authors.forename: M L
authors.initials: ML
authors.lastname: Penas-Martinez
authors.forename: E
authors.initials: E
authors.lastname: Rojo-Martinez
authors.forename: P
authors.initials: P
authors.lastname: Mulero
authors.forename: R
authors.initials: R
authors.lastname: Fernandez
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D000700:Analgesics / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D005260:Female; D006261:Headache / Q000188:drug therapy* / Q000503:physiopathology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000503:physiopathology; D010147:Pain Measurement; D055815:Young Adult
chemical_list: D000700:Analgesics; D000927:Anticonvulsants