title: Case report: Epicranial pain after radiotherapy for skull base meningioma - the first symptomatic epicrania fugax?
abstract: BACKGROUND
  To date, no symptomatic forms of epicrania fugax (EF) have been reported. Here, we describe the first EF-type pain to be probably caused by an underlying disorder.
  
  
  METHODS
  A 77-year-old woman started suffering from left V1-V2 trigeminal neuralgia at 72 years of age. Neurologic examination was normal. Magnetic resonance imaging (MRI) showed a left middle sphenoid wing meningioma compressing the left trigeminal nerve medially. After trying several neuromodulators, she received stereotactic radiotherapy. One month later, the episodes of facial pain were significantly diminished, but she started feeling brief electric paroxysms across her left hemicranium that were clinically identical to those of backwards EF. Serial MRI showed persistence of the meningioma without changes.
  
  
  CONCLUSIONS
  Although the pathogenesis of EF remains uncertain, this case is consistent with a symptomatic origin in the trigeminal root/pathway. The onset of the EF-like pain could have been caused by the compressive effect of the tumour or, most likely, by the radiation.
authors.affiliation: Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain martafmatarrubia@gmail.com.
authors.forename: Marta
authors.initials: M
authors.lastname: Fernández-Matarrubia
authors.affiliation: Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Gutiérrez-Viedma
authors.affiliation: Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.|Department of Medicine, Universidad Complutense, Madrid, Spain.
authors.forename: María-Luz
authors.initials: ML
authors.lastname: Cuadrado
mesh_terms: D000368:Aged; D005260:Female; D006261:Headache / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D008577:Meningeal Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000000981:diagnostic imaging* / Q000209:etiology*; D019292:Skull Base Neoplasms / Q000532:radiotherapy*
keywords: Epicrania fugax; meningioma; radiotherapy; trigeminal nerve; trigeminal neuralgia