PO-01 | Pediatric nummular headaches: a case series and physiopathological and nosography considerations
Abstract
Background: Nummular headache (NH) is a rare and often underdiagnosed primary headache characterized by a localized, well-circumscribed area of pain on the scalp. While documented in adults, its pediatric presentation remains poorly understood and scarcely reported.
Methods: We retrospectively analyzed six pediatric patients (aged 9–17) diagnosed with NH. For each case, clinical features including age at onset, pain localization and shape, associated symptoms, family history, treatment responses, and neuroimaging findings were evaluated. The diagnoses were assessed in light of the ICHD-3 criteria and compared to existing literature.
Results: Five patients presented with an episodic NH and one with a continuous form. The affected area ranged from 1 to 4 cm in diameter, with round, oval, and rectangular shapes reported. Allodynia was observed in two patients, and hypoesthesia in one. Four subjects experienced migraine-like features. One case was secondary to Langerhans cell histiocytosis. Neuroimaging was normal in all but one case. Therapeutic responses varied, with partial or complete improvement following NSAIDs, supplements (magnesium, PEA), or antiepileptics (gabapentin, carbamazepine). The occurrence of rectangular-shaped pain in two patients suggests a need for more flexible diagnostic parameters beyond the typical circular/oval definition in ICHD-3.
Conclusion: This case series highlights the clinical heterogeneity of NH in the pediatric population, including both…
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.
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