Headache Unit, Department of Neurology, Hospital General Universitario de Elche, Elche, Spain.
Headache. 2023 Jun;63(6):839-842. doi: 10.1111/head.14532.
Epicrania fugax (EF) is a primary headache consisting of brief paroxysms of pain, lasting 1-10 s, that move through different nerve territories of one hemicranium with a linear or zigzag trajectory, although there are some clinical variants. Preventive therapy with anti-seizure medication such as gabapentin and lamotrigine are most commonly used in patients presenting with frequent and non-remitting attacks. In some cases, greater occipital nerve blockades are used for short- or long-term relief. Here, we report two patients with a paroxysmal EF-type pain who meet the criteria for EF of the International Classification of Headache Disorders, 3rd edition, with clear triggers and autonomic ocular signs and who failed multiple preventive treatments, but had a sustained response to onabotulinumtoxinA.
短暂单侧颅痛发作（EF）是一种原发性头痛，由短暂的阵发性疼痛组成，持续 1-10 秒，沿一线性或锯齿状轨迹在同一侧头部的不同神经区域转移，尽管存在一些临床变异。预防性治疗常采用抗癫痫药物，如加巴喷丁和拉莫三嗪，用于治疗频繁且持续发作的患者。在某些情况下，使用枕大神经阻滞进行短期或长期缓解。在此，我们报告了 2 例符合国际头痛疾病分类第 3 版短暂单侧颅痛发作标准的阵发性 EF 型疼痛患者，有明确的触发因素和自主眼部征象，且多种预防性治疗无效，但对肉毒毒素 A 有持续反应。
