多灶性钱币状头痛的压痛敏感性图谱：一例报告
Pressure pain sensitivity map of multifocal nummular headache: a case report.
作者信息
Rodríguez Cristina, Herrero-Velázquez Sonia, Ruiz Marina, Barón Johanna, Carreres Alicia, Rodríguez-Valencia Edert, Guerrero Angel Luis, Madeleine Pascal, Cuadrado María Luz, Fernández-de-Las-Peñas César
机构信息
Neurology Department, Hospital Clínico Universitario de Valladolid, Avda. Ramón y Cajal 3, 47005, Valladolid, Spain,
出版信息
J Headache Pain. 2015;16:523. doi: 10.1186/s10194-015-0523-7. Epub 2015 Apr 30.
BACKGROUND
Nummular headache (NH) is most commonly a localized unifocal headache; however, some patients infrequently exhibit multifocal symptomatic painful head areas retaining all features of NH. We present the pressure pain sensitivity map of an adolescent with multifocal NH.
CASE PRESENTATION
We describe a case of a 14 year-old-girl with a 3-year history of continuous pain in four rounded areas, all of them with the same size and shape. Pressure pain thresholds (PPT) were assessed on 21 points over the scalp and over the symptomatic areas. A pressure pain sensitivity map of the head was constructed. The neurological exam was unremarkable, with neither sensory symptoms nor trophic changes within the painful areas. As previously shown, symptomatic points exhibited lower PPTs compared to the surrounding areas. The map reflected 4 restricted areas of mechanical hyperalgesia confined just to the painful areas. Treatment with gabapentin achieved complete remission.
CONCLUSION
This is the first pain sensitivity map of a patient with multifocal NH. Our results support peripheral mechanisms are maintained in multifocal NH.
背景
钱币状头痛（NH）通常是局限性单灶性头痛；然而，一些患者偶尔会出现多灶性症状性疼痛头部区域，保留了NH的所有特征。我们展示了一名患有多灶性NH的青少年的压痛敏感性图谱。
病例报告
我们描述了一名14岁女孩的病例，她有4个圆形区域持续疼痛3年的病史，所有区域大小和形状相同。在头皮和症状区域的21个点上评估压痛阈值（PPT）。构建了头部的压痛敏感性图谱。神经系统检查无异常，疼痛区域内既无感觉症状也无营养改变。如先前所示，症状点的PPT低于周围区域。图谱反映了仅局限于疼痛区域的4个机械性痛觉过敏受限区域。加巴喷丁治疗实现了完全缓解。
结论
这是首例多灶性NH患者的疼痛敏感性图谱。我们的结果支持多灶性NH中存在外周机制。
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