Headaches and craniofacial neuralgias described by Spanish authors

Spanish physicians have made important contributions to the nosology of headaches by describing various syndromes. In 1954, Eduardo Tolosa Colomer published the first case of Tolosa-Hunt syndrome, a clinical picture characterized by orbital pain and paralysis of extraocular muscles due to the presence of granulomatous inflammation in the cavernous sinus. In 1980, José Félix Martí Massó described pseudomigraine with cerebrospinal fluid pleocytosis, which manifests with episodes of migraine-type headache, transient neurological deficits, and elevated lymphocytes in the cerebrospinal fluid, usually with a benign prognosis. Since 2002, Juan Pareja and his group have identified several entities including: nummular headache, characterized by pain localized in a small coin-shaped area of the skull; primary trochlear headache, originating in the trochlea, in the superointernal angle of the orbit; epicrania fugax, which manifests with episodes of paroxysmal pain radiating along the surface of the head, following a linear or zigzag trajectory, and idiopathic ophthalmodynia and rhinalgia, which present with pain in the eyeball or nose with no apparent cause. Juan Pareja has also described several trigeminal terminal branch neuralgias, which are characterized by pain limited to the corresponding cutaneous territory and which typically respond to anesthetic blockade of the nerve. Finally, paroxysmal pressing headache, described by the same author, is manifested by brief episodes of unilateral pressing pain without accompanying symptoms. All these descriptions have been documented in scientific publications, and most of them have had a significant impact on clinical practice.