Montefiore Headache Center, Department of Neurology, Albert Einstein College of Medicine, 1575 Blondell Avenue, Suite 225, Bronx, NY 10461, USA.
Curr Pain Headache Rep. 2013 Jun;17(6):340. doi: 10.1007/s11916-013-0340-0.
Nummular headache (NH) is a rare headache disorder characterized by focal and well-circumscribed pain fixed within a rounded or oval/elliptical-shaped area of the head, typically 2 to 6 cm in diameter (Grosberg et al. Curr Pain Headache Rep 11:310-2, 2007). The disorder most commonly affects the parietal region and is almost always unilateral and side-locked. The pain is typically characterized as pressure-like, sharp, or stabbing and is usually mild to moderate in intensity. Many patients experience superimposed exacerbations of pain, lasting from seconds to days (Grosberg et al. Curr Pain Headache Rep 11:310-2, 2007). Distortions of sensation including hyperesthesia, hypoesthesia, allodynia, and paresthesias are frequently reported in the affected area. The temporal pattern may be episodic or chronic. Rarely, the disorder may be bifocal or multifocal, affecting various regions of the head simultaneously or in sequence. Treatment with gabapentin, tricyclic antidepressants, or botulinum toxin may be helpful. In this review of the more than 250 cases now reported in the literature, the epidemiology, clinical features, pathogenesis, differential diagnosis, and management of this disorder are discussed.
钱币状头痛（NH）是一种罕见的头痛疾病，其特征是局限性和边界清晰的疼痛局限在头部的圆形或椭圆形/椭圆形区域内，通常直径为 2 至 6 厘米（Grosberg 等人，Curr Pain Headache Rep 11:310-2, 2007）。该疾病最常影响顶叶区域，几乎总是单侧和单侧锁定。疼痛通常表现为压迫样、锐痛或刺痛，通常强度为轻度至中度。许多患者经历疼痛的叠加加重，持续数秒至数天（Grosberg 等人，Curr Pain Headache Rep 11:310-2, 2007）。受影响区域经常出现感觉扭曲，包括感觉过敏、感觉减退、痛觉过敏和感觉异常。时间模式可能是发作性或慢性的。罕见情况下，该疾病可能是双焦点或多焦点，同时或依次影响头部的不同区域。加巴喷丁、三环类抗抑郁药或肉毒杆菌毒素治疗可能会有所帮助。在对目前文献中报道的 250 多例病例的回顾中，讨论了该疾病的流行病学、临床特征、发病机制、鉴别诊断和管理。
