Nummular Headache.

[PURPOSE OF REVIEW] This article reviews nummular headache (NH), including the latest literature on the epidemiological and clinical features, the most recent proposed pathophysiology, and novel management.

[RECENT FINDINGS] NH is characterized by continuous or intermittent head pain confined to a focal circumscribed area (1-6 cm in diameter). It is usually of mild to moderate intensity, although some patients have severe continuous pain or disabling exacerbations. NH is a primary headache, though many secondary cases have been described. Evaluation requires exclusion of systemic and structural diseases. Gabapentin can be recommended as a first-line preventive treatment. If poorly tolerated or in refractory cases, botulinum toxin is a reasonable alternative. NH is a fairly common disorder in patients presenting to a headache clinic. Increased understanding of NH will lead to improved outcomes. Clinical trials would lead to enhanced knowledge of NH.