背景:数字头痛(NH)是一种罕见的头痛疾病,限定头皮的疼痛区域。过去几年对许多病例的描述支持了国际头痛协会将其重新分类为主要头痛,将其从以前在国际头痛障碍标准附录中的位置移开。
方法:数据来自RegistRare网络推动的关于罕见头痛的回顾性前瞻性观察研究,由七个意大利头痛中心组成的合作小组。根据某些原发性头痛的性别偏见,我们从性别角度进一步研究了NH患者.
结果:19例NH患者(11例男性,8名妇女)已被纳入研究。头痛发作在39岁,在诊断之前约8年。没有发现男性和女性之间的临床明显差异,包括治疗处方和头痛解决方案。值得注意的是,男性从NH发作到第一次头痛中心的平均时间更长,与女性相比(13.5vs.0.9年)。在接受治疗的患者中,有60%的患者使用非甾体类抗炎药有效治疗了NH发作。据报道,普瑞巴林和阿米替林预防头痛对40%和67%的治疗患者有效。分别。
结论:NH是一种原发性头痛,在颞部模式和疼痛特征方面具有临床异质性。需要进一步的研究来调查男性和女性表型的存在,通过澄清它是否可能与治疗目的相关。
BACKGROUND: Nummular headache (NH) is a rare headache disorder characterized by a small, circumscribed painful area of the scalp. The description of many cases in the last years has supported its re-classification as a primary headache from the International Headache Society, moving it from its previous placement in the Appendix of the International Criteria of Headache Disorders.
METHODS: Data were collected from a retro-prospective observational study about rare headaches promoted by the RegistRare Network, a collaborative group of seven Italian Headache Centres. According to the gender-biased profile of certain primary headaches, we have looked further NH patients from a gender perspective.
RESULTS: Nineteen NH patients (11 men, 8 women) have been enrolled in the study. Headache onset was at 39 years and preceded approximately 8 years the diagnosis. No clinically evident differences between men and women have been found, including treatment prescriptions and headache resolution. Of note, the mean time from the onset of NH to the first visit in a Headache Centre was longer in men, compared with women (13.5 vs. 0.9 years). NH attacks were efficaciously treated with nonsteroidal anti-inflammatory drugs in 60% of patients receiving treatment. Headache prophylaxis with pregabalin and amitriptyline has been reported as effective in 40% and 67% of the treated patients, respectively.
CONCLUSIONS: NH is a primary headache clinically heterogeneous in terms of temporal patterns and pain characteristics. Further research is needed to investigate the existence of male and female phenotypes, by clarifying whether it may be relevant for therapeutic purposes.