• Sonia Herrero-Velázquez, Ángel L Guerrero-Peral, Patricia Mulero, M Luz Peñas-Martínez, Elisa Cortijo, Sara Miranda, Esther Rojo-Martinez, Ana Henao, Raquel Rodríguez, María Pedraza, M Luisa Hurtado, Javier Marco-Llorente, M Nieves Fernández-Buey, and Rosa Fernández.
• Hospital Clinico Universitario de Valladolid, 47005 Valladolid, Espana.
• Rev Neurol. 2011 Nov 1;53(9):531-7.

IntroductionEpicrania fugax is a recently reported condition consisting in brief painful paroxysms that begin in the posterior regions of the brain and irradiate towards the ipsilateral eye, nose or temple.AimsTo present 18 cases of epicrania fugax from a monographic headache centre in a tertiary hospital and to analyse their demographic and clinical features, as well as the indication and response to prophylactic treatment.Patients And MethodsBetween March 2008, when epicrania fugax was first reported, and March 2011, of a total of 1210 patients who were attended in that service (1.48%), 18 (12 females and 6 males) were diagnosed as suffering from this condition. Six of these cases had been published earlier.ResultsThe mean age at onset was 42.5 ± 17.7 years (range: 23-82 years). They presented painful paroxysms that began in the occipital (n = 11; 61.1%), parietal (n = 6; 33.3%) or parieto-occipital (n = 1; 5.6%) regions and irradiated towards the ipsilateral eye (n = 12; 66.6%) or temple (n = 6; 33.3%); the whole process lasted less than 15 seconds. Most of them described the pain as lancinating or stabbing. In 10 cases (55.5%) a pain remained in the area where the paroxysms began, which in 6 cases (33.3%) was limited to a well-defined circular area and met the criteria for classification as nummular headache. In 12 cases (66.6%), prophylactic treatment was used, above all lamotrigine and gabapentin, with varying results.ConclusionOur aim is to back the proposal of epicrania fugax as a new syndrome with a well-defined clinical spectrum. It does not appear to be an exceptional condition and further knowledge about it will probably give rise to the description of new series. Treatment is often necessary and, although further information and experience are needed, gabapentin and lamotrigine both play a promising role.

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