Epicrania fugax is a rare and relatively newly described type of headache disorder characterized by sudden, brief, and severe episodes of head pain that usually move linearly across the scalp. The pain typically starts in one area of the head and shoots to another area, often from the occipital (back) region to the frontal (front) region, or vice versa. The episodes are very short, lasting from a few seconds to a few minutes, and can be triggered by head movements or touching the scalp.

Characteristics of Epicrania Fugax: Pain Trajectory: The pain usually moves in a linear or zigzag pattern across the scalp. The direction can be either forward or backward.

Duration: The pain episodes are typically very brief, generally lasting between 1 second and 1 minute.

Intensity: The pain can be sharp or stabbing and is often described as severe.

Frequency: The attacks can occur several times a day or can be less frequent.

Diagnosis: Since epicrania fugax is a rare condition and its symptoms can be similar to other headache disorders, diagnosing it can be challenging. The diagnosis is primarily clinical, based on the patient's description of their symptoms. There are no specific tests for epicrania fugax, but tests may be conducted to rule out other causes of head pain, such as neuralgias, migraines, or vascular issues.

Possible Causes: The exact cause of epicrania fugax is not well understood, but it is thought to involve abnormal nerve activity, possibly related to the peripheral nerves in the scalp. Some experts suggest it might be a variant of primary headache disorders like trigeminal neuralgia or could be associated with other episodic headache syndromes.

Treatment: Treatment options are limited due to the rarity and recent recognition of the condition. The following approaches have been used:

Medications:

Indomethacin: Some patients have reported relief with indomethacin, a nonsteroidal anti-inflammatory drug (NSAID) that is also effective for other types of headache disorders, such as paroxysmal hemicrania.

Gabapentin: This medication, commonly used for neuropathic pain, has been found helpful in some cases.

Other NSAIDs: May be tried to manage symptoms.

Other Treatments: Due to the brief nature of the pain, preventive treatments are often considered, although their effectiveness can vary widely between individuals.

Management: Patients may benefit from keeping a headache diary to track the occurrences, triggers, and characteristics of the pain, which can help in managing the condition and tailoring treatments. Regular follow-ups with a healthcare provider specializing in headache disorders are crucial for managing symptoms effectively.

The condition is still under research, and ongoing studies aim to better understand its pathophysiology and find more effective treatments. Patients diagnosed with epicrania fugax should seek care from a headache specialist or a neurologist familiar with rare headache syndromes.