PDF
Case Report | Open Access
Atypical Nummular Headache or Circumscribed Migraine: The Utility of Pressure Algometry
Johanna Barón,1 Cristina Rodríguez,1 Marina Ruiz,1 María Isabel Pedraza,1 Ángel Luis Guerrero
,1 Pascal Madeleine,2 María Luz Cuadrado,3 and César Fernández-de-las-Peñas41Neurology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
2Centre for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
3Neurology Department, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Spain
4Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
Abstract
A peripheral mechanism has been proposed for nummular headache; however, there have been descriptions of atypical features resembling migraine. The authors describe a case in which algometry assessment facilitated the discrimination between atypical nummular headache and circumscribed migraine. A 21-year-old woman presented with a history of focal episodic pain in a circumscribed area on the left frontal region. The algometry study showed a unilateral and diffuse decrease of the pain pressure thresholds with frontal predominance, as has been proposed for migraine patients. This result led the authors to introduce a more specific preventive therapy with topiramate, with significant relief. In conclusion, cartographic investigation of pressure pain sensitivity is a simple tool that can help to differentiate between nummular headache and migraine. Further confirmatory investigations are needed.
Copyright
Copyright © 2015 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
