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univadis
IHSDiagnosisICD-10
A13.7.1Nummular headache  
Previously used terms Coin-shaped cephalgia

Description:

Pain in a small circumscribed area of the head in the absence of any lesion of the underlying structures.

Diagnostic criteria:

  1. Mild to moderate head pain fulfilling criteria B and C:
  2. Pain is felt exclusively in a rounded or elliptical area typically 2-6 cm in diameter
  3. Pain is chronic and either continuous or interrupted by spontaneous remissions lasting weeks to months
  4. Not attributed to another disorder

Comments:

There is a slight female preponderance.

Nummular headache is probably a localised terminal branch neuralgia of the trigeminal nerve.

The painful area may be localised in any part of the head but is usually in the parietal region. The pain remains confined to the same symptomatic area which does not change in shape or size over time. Lancinating exacerbations lasting for several seconds or gradually increasing over 10 minutes to 2 hours may be superimposed on the base-line pain. During and between symptomatic periods, the affected area may show variable combinations of hypaesthesia, dysaesthesia, paraesthesia, tenderness and/or discomfort.

Spontaneous periods of remission have been observed in 38% of patients, with return to continuous pain after weeks or months.

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