Headache Unit, Neurology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
Neurology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain.
Cephalalgia. 2020 Aug;40(9):959-965. doi: 10.1177/0333102420920646. Epub 2020 Apr 15.
Epicrania fugax consists of brief paroxysms of pain, which radiate in a line or in zigzag trajectory across the surface of the scalp or the face.
A prospective, descriptive study was performed in five patients presenting with an epicrania fugax-type pain with extracephalic irradiation.
All patients were women, and the mean age at onset was 59.8 (standard deviation, 10.9). They had unilateral paroxysms of electrical pain starting at a particular point in the head (parietal, n = 3; vertex, n = 1; frontal, n = 1) and rapidly radiating downwards in a lineal trajectory to reach extracephalic regions (ipsilateral limbs, n = 2; shoulder, n = 2; low neck, n = 1) in 1-3 seconds. Pain intensity was moderate or severe. Three patients had nummular headache at the point where the paroxysms originated. One patient had spontaneous remission, and four patients achieved complete or almost complete response with therapy (onabotulinumtoxinA, n = 2; indomethacin, n = 1; amitriptyline, n = 1; lamotrigine, n = 1).
The spectrum of epicrania fugax may include paroxysms with extracephalic irradiation. The propagation of pain beyond the head and the face supports the involvement of central mechanisms in the pathophysiology of this entity.
短暂性偏头痛是一种短暂的阵发性疼痛，疼痛呈线状或锯齿状辐射至头皮或面部。
对 5 例表现为颅外放射性短暂性偏头痛样疼痛的患者进行前瞻性描述性研究。
所有患者均为女性，发病时的平均年龄为 59.8 岁（标准差为 10.9）。她们均有单侧阵发性电击样疼痛，起始于头部的特定点（顶骨，n=3；头顶，n=1；额骨，n=1），并迅速沿线状轨迹向下辐射至颅外区域（同侧肢体，n=2；肩部，n=2；颈部低位，n=1），时间在 1-3 秒内。疼痛强度为中度或重度。3 例患者在阵发性疼痛起始处有钱币状头痛。1 例患者自发性缓解，4 例患者经治疗后完全或几乎完全缓解（肉毒毒素 A，n=2；吲哚美辛，n=1；阿米替林，n=1；拉莫三嗪，n=1）。
短暂性偏头痛的范围可能包括颅外放射的阵发性疼痛。疼痛超出头部和面部的传播支持中枢机制参与该疾病的病理生理学。
