Evidence Hub

Cephalalgia heterotopica: a case series of lower half face migraine

C. Bordini, H. M. da Silva

Headache Medicine, 2022

Abstract

Introduction

Migraine is a common and very disabling neurological disease. It typically causes severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. According to the definition of headache, the pain should be located in the head or in the face above the orbitomeatal line. Beyond this classical view, recent evidence has shown that it could be an arbitrary boundary, and other clinical features can prevail during the diagnosis process.

Objective

This consecutive case series study aimed to report clinical features, treatment, and outcome of 5 patients with a lower-half facial presentation of migraine.

Materials and Methods

Case series of our Headache Clinic. Data disclosure was authorized by the patients through an informed consent form.

Results

Of the 5 patients, 3 were women and 2 were men. Mean age was 34, 6 (13-56 years). The mean age of symptoms onset was 15,2 (11-29 years).

All patients described a throbbing, moderate to severe pain in the malar area.

Four patients reported frequent phonophobia and photophobia accompanying pain attacks. One patient reported great relief of pain with rizatriptan and another with sumatriptan. Preventive treatment with pizotifen, propranolol, flunarizine, amitriptyline, divalproex sodium, and pregabalin was useful. All patients underwent extensive dental and otolaryngological evaluation and treatment, which were worthless.…

How strong is the evidence?

Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free