There is hardly any person on earth who does not know what a headache is. Almost everyone at some point in life must have experienced headache. Headache is unpleasant and intolerable pain in head. There are several types of headache described in medical literature. This may vary according to the frequency, cause, location, modality, etc.
Researchers and medical fraternity believe that nummular headache is caused due to damage or an injury to the trigeminal nerve. Trigeminal nerve is 5th cranial nerve. This nerve is responsible for facial sensation and motor function such as chewing, biting, etc.
The typical clinical feature of nummular headache is coin shaped headache. This means pain occurs in elliptical or circular area localized usually on one side of head. Whenever an acute episode occurs, pain remains in that particular coin shaped area. Pain occurs in the same fixed area every time. Nummular headache is mild to moderate. Individual may suffer from episodes of headache that may last constantly for few days or weeks before spontaneous remission; after few month headache returns. The circular painful area is around 2 to 6 cm in diameter. Pain is on the parietal portion of head meaning on the sides of head. Other concomitant symptoms include tenderness on touch and tingling sensation in the painful area together with allodynia.
Diagnosis and treatment:
For diagnosis of nummular headache, the doctor takes complete medical history of the patient before he physically examines the patient. Often he asks the patient whether any dental procedure were performed. Further tests include CT scan or MRI of brain. These radiological tests help to rule out any brain lesion or a growth. The doctor also checks for herpes zoster infection, bone infection, multiple myeloma which may also present with similar distinct pain pattern.
Nummular headache is a rare primary headache. There is no specific treatment module derived to treat nummular headache. However, non-steroidal anti inflammatory medicines, gabapentin, antidepressants have been successful in alleviating the pain. Even Botox injection is found to be effective as it blocks the nerve connection. Since the headache is chronic and recurs from time to time, reassurance is often beneficial for successful treatment. Homeopathic medicines such as Spigelia, Natrum Mur, Sangunaria, etc are found to be beneficial in such type of headache.