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Epicrania fugax combining forward and backward paroxysms in the same patient: the first four cases
BACKGROUND: The first description of epicrania fugax (EF) reported brief painful paroxysms that start in posterior regions of the scalp and move forward to reach the ipsilateral forehead, eye, or nose. A backward variation, wherein pain stems from frontal areas and radiates to the posterior scalp, h...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove Medical Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5499947/ https://www.ncbi.nlm.nih.gov/pubmed/28721087 http://dx.doi.org/10.2147/JPR.S135810 |
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author | Barón-Sánchez, Johanna Gutiérrez-Viedma, Álvaro Ruiz-Piñero, Marina Pérez-Pérez, Alicia Guerrero, Ángel Luis Cuadrado, María L |
author_facet | Barón-Sánchez, Johanna Gutiérrez-Viedma, Álvaro Ruiz-Piñero, Marina Pérez-Pérez, Alicia Guerrero, Ángel Luis Cuadrado, María L |
author_sort | Barón-Sánchez, Johanna |
collection | PubMed |
description | BACKGROUND: The first description of epicrania fugax (EF) reported brief painful paroxysms that start in posterior regions of the scalp and move forward to reach the ipsilateral forehead, eye, or nose. A backward variation, wherein pain stems from frontal areas and radiates to the posterior scalp, has also been acknowledged. We report four patients with features reminiscent of EF and the coexistence of forward and backward pain paroxysms. METHODS: We considered all patients attending the headache outpatient office at two tertiary hospitals from March 2008 to March 2016. We enrolled four patients with paroxysms fulfilling criteria for EF and a combination of forward and backward radiations. RESULTS: In all cases, pain paroxysms moved both in forward and backward directions with either a zigzag (n=2) or linear (n=2) trajectory. Three patients presented two stemming points, in the occipital scalp and forehead (n=2) or in the parietal area and eye (n=1), whereas the fourth patient only had a stemming point located in the parietal region. Pain quality was mainly stabbing, and its intensity was moderate (n=1) or severe (n=3). The duration of the paroxysms was highly variable (3–30 seconds), and two patients reported autonomic symptoms. CONCLUSION: The clinical picture presented by our patients does not fit with other types of known headache or neuralgia syndromes; we propose it corresponds to a bidirectional variant of EF. |
format | Online Article Text |
id | pubmed-5499947 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-54999472017-07-18 Epicrania fugax combining forward and backward paroxysms in the same patient: the first four cases Barón-Sánchez, Johanna Gutiérrez-Viedma, Álvaro Ruiz-Piñero, Marina Pérez-Pérez, Alicia Guerrero, Ángel Luis Cuadrado, María L J Pain Res Case Series BACKGROUND: The first description of epicrania fugax (EF) reported brief painful paroxysms that start in posterior regions of the scalp and move forward to reach the ipsilateral forehead, eye, or nose. A backward variation, wherein pain stems from frontal areas and radiates to the posterior scalp, has also been acknowledged. We report four patients with features reminiscent of EF and the coexistence of forward and backward pain paroxysms. METHODS: We considered all patients attending the headache outpatient office at two tertiary hospitals from March 2008 to March 2016. We enrolled four patients with paroxysms fulfilling criteria for EF and a combination of forward and backward radiations. RESULTS: In all cases, pain paroxysms moved both in forward and backward directions with either a zigzag (n=2) or linear (n=2) trajectory. Three patients presented two stemming points, in the occipital scalp and forehead (n=2) or in the parietal area and eye (n=1), whereas the fourth patient only had a stemming point located in the parietal region. Pain quality was mainly stabbing, and its intensity was moderate (n=1) or severe (n=3). The duration of the paroxysms was highly variable (3–30 seconds), and two patients reported autonomic symptoms. CONCLUSION: The clinical picture presented by our patients does not fit with other types of known headache or neuralgia syndromes; we propose it corresponds to a bidirectional variant of EF. Dove Medical Press 2017-06-23 /pmc/articles/PMC5499947/ /pubmed/28721087 http://dx.doi.org/10.2147/JPR.S135810 Text en © 2017 Barón-Sánchez et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Case Series Barón-Sánchez, Johanna Gutiérrez-Viedma, Álvaro Ruiz-Piñero, Marina Pérez-Pérez, Alicia Guerrero, Ángel Luis Cuadrado, María L Epicrania fugax combining forward and backward paroxysms in the same patient: the first four cases |
title | Epicrania fugax combining forward and backward paroxysms in the same patient: the first four cases |
title_full | Epicrania fugax combining forward and backward paroxysms in the same patient: the first four cases |
title_fullStr | Epicrania fugax combining forward and backward paroxysms in the same patient: the first four cases |
title_full_unstemmed | Epicrania fugax combining forward and backward paroxysms in the same patient: the first four cases |
title_short | Epicrania fugax combining forward and backward paroxysms in the same patient: the first four cases |
title_sort | epicrania fugax combining forward and backward paroxysms in the same patient: the first four cases |
topic | Case Series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5499947/ https://www.ncbi.nlm.nih.gov/pubmed/28721087 http://dx.doi.org/10.2147/JPR.S135810 |
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