Background/objective Nummular headache (NH) is a primary headache disorder characterised by intermittent or continuous scalp pain, affecting a small circumscribed area of the scalp. As there are limited data in the literature on NH, we conducted this review to evaluate demographic characteristics and factors associated with complete resolution of the headache, and effectiveness of treatment options. Methods We performed a systematic review of cases reported through PubMed database, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol and ‘nummular headache’, ‘coin-shaped headache’ and ‘coin-shaped cephalalgia’ keywords. Analysis was performed by using χ2 test and Wilcoxon rank-sum test. For individual interventions, the response rate (RR%) of the treatment was calculated. Results We analysed a total of 110 NH cases, with median age 47 years and age of pain onset 42 years. Median duration to make correct diagnosis was 18 months after first attack. The median intensity of each attack was 5/10 on verbal rating scale over 4 cm diameter with duration of attack <30 min. Patients with NH had median three attacks per day with frequency of 9.5 days per month. 40 (57.97%) patients had complete resolution of the headache after treatment. Patients with complete resolution were younger, more likely to be female, and were more likely to have diagnosis within year. Patients with complete resolution more likely to have received treatment with onabotulinum toxin A (botulinum toxin type A (BoNT-A)), and gabapentin compared with patients without complete resolution. Most effective interventions were gabapentin (n=34; RR=67.7%), non-steroidal anti-inflammatory drugs (NSAIDs) (n=32; RR=65.6%), BoNT-A (n=12; RR=100%) and tricyclic antidepressant (n=9; RR=44.4%). Conclusion Younger patients, female sex and early diagnosis were associated with complete resolution. NSAIDs, gabapentin and BoNT-A were most commonly used medications, with significant RRs.

中文翻译：

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钱币状头痛的特点及治疗效果：110例的系统回顾与分析


背景/目的 钱币状头痛 (NH) 是一种原发性头痛疾病，其特征是间歇性或持续性头皮疼痛，影响头皮的小范围区域。由于有关 NH 的文献数据有限，我们进行了本次综述，以评估人口特征和与头痛完全缓解相关的因素以及治疗方案的有效性。方法 我们使用系统评价和荟萃分析协议的首选报告项目以及“钱币状头痛”、“硬币状头痛”和“硬币状头痛”关键词，对通过 PubMed 数据库报告的病例进行了系统评价。采用χ2检验和Wilcoxon秩和检验进行分析。对于个体干预，计算治疗的反应率（RR%）。结果 我们总共分析了 110 例 NH 病例，中位年龄 47 岁，疼痛发病年龄 42 岁。做出正确诊断的中位持续时间是首次发作后 18 个月。在直径超过 4 厘米的言语评级量表上，每次发作的中位强度为 5/10，发作持续时间为 <30 分钟。 NH 患者平均每天发作 3 次，频率为每月 9.5 天。 40 名（57.97%）患者治疗后头痛完全缓解。完全缓解的患者更年轻，更有可能是女性，并且更有可能在一年内得到诊断。与未完全缓解的患者相比，完全缓解的患者更有可能接受 A 型肉毒杆菌毒素（A 型肉毒杆菌毒素 (BoNT-A)）和加巴喷丁治疗。最有效的干预措施是加巴喷丁（n=34；RR=67.7%）、非甾体抗炎药（NSAID）（n=32；RR=65.6%）、BoNT-A（n=12；RR=100%）和三环类抗抑郁药（n=9；RR=44.4%）。 结论 年轻患者、女性和早期诊断与完全缓解相关。 NSAIDs、加巴喷丁和 BoNT-A 是最常用的药物，具有显着的 RR。