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Nummular Headache – Symptoms – Treatment – Prognosis
Nummular, or coin-shaped headache, is a rare form of primary headache affecting 0.0064% of population.
Nummular headache presents as a pain in a small rounded area of the scalp. Pain is rarely severe but is rather constant and annoying. Pain may sometimes increase in intensity to a stabbing quality for a short period of time.
Nummular headache tends to always stay in the same spot and is unlikely to change the location. Occasionally the pain may be present in two separate locations.
No local scalp changes can be seen but the painful area is usually hypersensitive to touch.
Nummular headache lasts for years alternated with remissions in some patients. Remissions may last for years.
Bone disease, such as bone metastases or Paget disease, have to be ruled out.
There is no proven treatment for nummular headache. Gabapentin and Indomethacin are reported being effective in some. Other medications (Topamax, Melatonin) may be tried.
Those patients, who I thought had nummular headaches, did not respond to Indocin and Gabapentin.