[Epicrania fugax: the clinical characteristics of a series of 18 patients].
BACKGROUND
Epicrania fugax is a recently reported condition consisting in brief painful paroxysms that begin in the posterior regions of the brain and irradiate towards the ipsilateral eye, nose or temple.


OBJECTIVE
To present 18 cases of epicrania fugax from a monographic headache centre in a tertiary hospital and to analyse their demographic and clinical features, as well as the indication and response to prophylactic treatment.


METHODS
Between March 2008, when epicrania fugax was first reported, and March 2011, of a total of 1210 patients who were attended in that service (1.48%), 18 (12 females and 6 males) were diagnosed as suffering from this condition. Six of these cases had been published earlier.


RESULTS
The mean age at onset was 42.5 ± 17.7 years (range: 23-82 years). They presented painful paroxysms that began in the occipital (n = 11; 61.1%), parietal (n = 6; 33.3%) or parieto-occipital (n = 1; 5.6%) regions and irradiated towards the ipsilateral eye (n = 12; 66.6%) or temple (n = 6; 33.3%); the whole process lasted less than 15 seconds. Most of them described the pain as lancinating or stabbing. In 10 cases (55.5%) a pain remained in the area where the paroxysms began, which in 6 cases (33.3%) was limited to a well-defined circular area and met the criteria for classification as nummular headache. In 12 cases (66.6%), prophylactic treatment was used, above all lamotrigine and gabapentin, with varying results.


CONCLUSIONS
Our aim is to back the proposal of epicrania fugax as a new syndrome with a well-defined clinical spectrum. It does not appear to be an exceptional condition and further knowledge about it will probably give rise to the description of new series. Treatment is often necessary and, although further information and experience are needed, gabapentin and lamotrigine both play a promising role.
Hospital Clinico Universitario de Valladolid, 47005 Valladolid, Espana.
Sonia
S
Herrero-Velázquez
Ángel L
ÁL
Guerrero-Peral
Patricia
P
Mulero
M Luz
ML
Peñas-Martínez
Elisa
E
Cortijo
Sara
S
Miranda
Esther
E
Rojo-Martinez
Ana
A
Henao
Raquel
R
Rodríguez
María
M
Pedraza
M Luisa
ML
Hurtado
Javier
J
Marco-Llorente
M Nieves
MN
Fernández-Buey
Rosa
R
Fernández
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult