Purpose of Review

In this review, we examine reported cases of cephalgia alopecia including the initial case report from 2006. The goal is to review the clinical description, pathophysiology, diagnosis, and treatment of cephalgia alopecia.

Recent Findings

The pathophysiology of the headache and hair loss in cephalgia alopecia is believed to be related to neuroregulation of skin and nerve. It is hypothesized that the headache causes recurrent activation of trigeminal and upper cervical branches that innervate the hair cells. The repetitive activation of C fibers results in depletion of substance P and calcitonin gene-related peptide (CGRP), which leads to loss of hair growth promotion and disruption of immune system regulation. A case report suggests that cephalgia alopecia and nummular headache with trophic changes may represent a spectrum of disease involving head pain and cutaneous changes.

Summary

Cephalgia alopecia is a rare headache disorder described as recurrent burning, stabbing head, and neck pain that is followed by hair loss in the corresponding region of the scalp. The mainstay treatment for both pain and hair loss is OnabotulinumtoxinA (onabotA). A patient’s clinical history and response to onabotA treatment is used to make the diagnosis. Future research is needed to examine the hypothesized disease continuum of head pain and cutaneous changes. It will also be beneficial to assess if the grid-like onabotA technique used in nummular headache is effective in cephalgia alopecia. In addition, further studies are needed to assess the proposed pathophysiology.

中文翻译：

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头疼症脱发。

审查目的

在这篇综述中，我们检查了包括2006年的首次病例报告在内的头疼脱发的报告病例。目标是回顾头疼脱发的临床描述，病理生理，诊断和治疗。

最近的发现

头痛和脱发的头痛的病理生理学被认为与皮肤和神经的神经调节有关。据推测，头痛会导致支配毛细胞的三叉和上颈分支的反复激活。C纤维的重复激活导致P物质和降钙素基因相关肽（CGRP）的消耗，这会导致促进毛发生长的丧失和免疫系统调节的破坏。病例报告表明，伴有营养改变的头疼脱发和数字头痛可能代表了涉及头痛和皮肤变化的一系列疾病。

概要

头痛性脱发是一种罕见的头痛疾病，被描述为反复发作的烧伤，刺伤头部和颈部疼痛，随后在头皮的相应区域脱发。疼痛和脱发的主要治疗方法是OnabotulinumtoxinA（onabotA）。使用患者的临床病史和对onabotA治疗的反应进行诊断。需要进一步的研究来检查假设的头痛和皮肤变化的疾病连续性。评估在数字头痛中使用的网格状onabotA技术对于头疼脱发是否有效也将是有益的。另外，需要进一步的研究来评估提议的病理生理学。