Nummular Headache

  • Danielle WilhourEmail author
  • Claire E. J. Ceriani
  • Stephanie J. Nahas
Headache (R.B. Halker Singh, Section Editor)
Part of the following topical collections:
  1. Topical Collection on 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.


Nummular headache Coin-shaped headache Circumscribed cephalalgia Epicrania Primary headache 


Compliance with Ethical Standards

Conflict of Interest

Danielle Wilhour and Claire E.J. Ceriani each declare no potential conflicts of interest. Stephanie J. Nahas reports personal fees from Allergan, Amgen, Avanir, electroCore, Eli Lilly, Supernus, Teva, and Biohaven, outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Danielle Wilhour
    • 1
    Email author
  • Claire E. J. Ceriani
    • 1
  • Stephanie J. Nahas
    • 1
  1. 1.Jefferson Headache CenterPhiladelphiaUSA

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