title: Linear headache: a recurrent unilateral head pain circumscribed in a line-shaped area.
abstract: BACKGROUND
  A headache circumscribed in a line-shaped area but not confined to the territory of one particular nerve had ever been described in Epicrania Fugax (EF) of which the head pain is moving and ultrashort. In a 25-month period from Feb 2012 to Mar 2014, we encountered 12 patients with a paroxysmal motionless head pain restricted in a linear trajectory. The head pain trajectory was similar to that of EF, but its all other features obviously different from those of EF. We named this distinctive but undescribed type of headache linear headache (LH).
  
  
  METHODS
  A detailed clinical feature of the headache was obtained in all cases to differentiate with EF, trigeminal autonomic cephalalgias (TACs) and cranial neuralgia. Similarities and differences in clinical features were compared between LH and migraine.
  
  
  RESULTS
  The twelve LH patients (mean age 43.9 ± 12.2) complained of a recurrent, moderate to severe, distending (n = 9), pressure-like (n = 3) or pulsating (n = 3) pain within a strictly unilateral line-shaped area. The painful line is distributed from occipital or occipitocervical region to the ipsilateral eye (n = 5), forehead (n = 6) or parietal region (n = 1). The pain line has a trajecory similar to that of EF but no characteristics of moving. The headache duration would be ranged from five minutes to three days, but usually from half day to one day in most cases (n = 8). Six patients had the accompaniment of nausea with or without vomiting, and two patients had the accompaniment of ipsilateral dizziness. The attacks could be either spontaneous (n = 10) or triggered by noise, depression and resting after physical activity (n = 1), or by stress and staying up late (n = 1). The frequency of attacks was variable. The patients had well response to flunarizine, sodium valproate and amitriptyline but not to carbamazepine or oxcarbazepine. LH is different from EF, trigeminal autonomic cephalalgias (TACs) and cranial neuralgia, but it had couple of features similar to that of migraine.
  
  
  CONCLUSIONS
  The clinical picture of LH might be a subtype of migraine, or represent a novel syndrome.
authors: Department of Neurology, Epilepsy and Headache group, The First Hospital of Anhui Medical University, Jixi Road 218, Hefei 230022, China. yw4d@hotmail.com.
authors: Yu
authors: Y
authors: Wang
authors: Miao-Miao
authors: MM
authors: Tian
authors: Xian-Hong
authors: XH
authors: Wang
authors: Xiao-Qun
authors: XQ
authors: Zhu
authors: Ying
authors: Y
authors: Liu
authors: Ya-Nan
authors: YN
authors: Lu
authors: Qing-Qing
authors: QQ
authors: Pan
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006261:Headache / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis*; D051303:Trigeminal Autonomic Cephalalgias / Q000175:diagnosis*; D055815:Young Adult