Background

Epicrania fugax consists of brief paroxysms of pain, which radiate in a line or in zigzag trajectory across the surface of the scalp or the face.

Methods

A prospective, descriptive study was performed in five patients presenting with an epicrania fugax-type pain with extracephalic irradiation.

Results

All patients were women, and the mean age at onset was 59.8 (standard deviation, 10.9). They had unilateral paroxysms of electrical pain starting at a particular point in the head (parietal, n = 3; vertex, n = 1; frontal, n = 1) and rapidly radiating downwards in a lineal trajectory to reach extracephalic regions (ipsilateral limbs, n = 2; shoulder, n = 2; low neck, n = 1) in 1–3 seconds. Pain intensity was moderate or severe. Three patients had nummular headache at the point where the paroxysms originated. One patient had spontaneous remission, and four patients achieved complete or almost complete response with therapy (onabotulinumtoxinA, n = 2; indomethacin, n = 1; amitriptyline, n = 1; lamotrigine, n = 1).

Conclusion

The spectrum of epicrania fugax may include paroxysms with extracephalic irradiation. The propagation of pain beyond the head and the face supports the involvement of central mechanisms in the pathophysiology of this entity.

中文翻译：

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头外照射阵发性头痛：在一系列 5 名患者中提出一种新的 epicrania fugax 变种。

背景

Epicrania fugax 由短暂的阵发性疼痛组成，疼痛以一条线或锯齿形轨迹辐射穿过头皮或面部表面。

方法

一项前瞻性描述性研究对 5 名因头外照射出现一过性外显性疼痛的患者进行了研究。

结果

所有患者均为女性，平均发病年龄为 59.8 岁（标准差为 10.9）。他们从头部的特定点（顶叶，n = 3；顶点，n = 1；额叶，n = 1）开始单侧阵发性电痛，并沿直线轨迹快速向下辐射到达脑外区域（同侧肢体， n = 2；肩膀，n = 2；低颈，n = 1) 在 1-3 秒内。疼痛强度为中度或重度。三名患者在发作时出现麻木样头痛。1 名患者自发缓解，4 名患者通过治疗达到完全或几乎完全缓解（肉毒杆菌毒素 A，n = 2；吲哚美辛，n = 1；阿米替林，n = 1；拉莫三嗪，n = 1）。

结论

一过头颅的范围可能包括头外照射的阵发性。疼痛超出头部和面部的传播支持该实体的病理生理学中枢机制的参与。