First three cases of scalp temperature change in symptomatic areas affected by nummular headache: a case report

BACKGROUND: Nummular headache is a distinct headache disorder characterized by a rounded or elliptical symptomatic area that is typically 2 to 6 cm in diameter and does not change in shape or size with time. Although the pathomechanism is still not clear, nummular headache is thought to be a primary headache disorder. To date, more than 250 cases have been reported; the symptoms of this disease vary, but no cases with scalp temperature changes in the symptomatic areas have been reported yet. In this study, we present three patients with a new manifestation of nummular headache, in which the symptomatic areas of the scalp were colder or warmer than normal areas; we believe that our work might be helpful for medical practitioners and researchers. CASE PRESENTATION: The temperature differences between the symptomatic areas and the normal areas were tested in three patients with nummular headache accompanied by changes in scalp temperature. Three patients’ symptomatic areas were either colder or warmer than the normal areas. In every case, we took measurements from the painful site and from the opposite side of the head. The margin of error was 0.01 °C, and the difference was statistically significant (P < 0.01). CONCLUSION: We firmly believe that our study will provide an enriched understanding of the variation in clinical manifestations of nummular headache. Our observations might also have clinical implications regarding the pathomechanism of this disease, which remains largely unclear at present.