In 2007, Dr. Fred Sheftell and Dr. Timothy Steiner diagnosed Harry Potter
with probable Migraine based on evidence in the first five books of the Harry
Potter series. (see
Is Harry Potter a Migraineur?)
In a recent
letter to the editor of the journal Headache, Dr. Sylvia Mohen and Dr.
Matthew Robbins offer a different diagnosis based on a review of Harry's
symptoms in light of the completion of the series. They opine that Harry's
headaches, as described throughout the series, appear to fit the proposed
criteria that appear in the appendix of the current version of the International
Classification of Headache Disorders, 2nd edition (ICHD-II), for nummular
The reasons Mohen and Robbins cite for classifying Harry's headaches as NH
- the location of his lightning bolt scar (somewhat visible in the photo
- the description of his pain as searing and burning
- his pain being felt exclusively in a well defined round or elliptical
- his pain being interrupted by spontaneous remissions
- there have been some cases of nummular headache starting with trauma,
such as the trauma that resulted in Harry's scar
Mohen and Robbins state:
"The major essence of Harry Potter’s headache disorder is that it is
post-traumatic, severe, and well circumscribed, most consistent with NH. As a
relatively recently described headache phenomenon, NH has mostly been
described in an older patient population with a female predominance.
However, larger series indicate that adolescents may experience NH.9,10,12
As its true prevalence and incidence are uncertain, its relative lack of
reporting among this age group may be attributable to underrecognition
rather than a true absence of NH in this demographic, underscoring the
underrecognition of headache in the pediatric population in general, a major
emphasis of Sheftell et al that we agree with wholeheartedly."1
Summary and comments:
Regardless of whether Harry Potter has Migraines or nummular headaches, the
speculation among Migraine and headache specialists, the publication of their
work in medical journals, and the publicity around those publications result in
positive attention being paid to headache disorders. This was part of Dr.
Sheftell's original intent. When I interviewed him back in 2007, he told me:
"I've always been a big fan of JK Rowling's series on Harry Potter and
find her imaginative and creative and able to teach a lot of life lessons to
children and adolescents via metaphor and fantasy. I, of course, recognized
Harry had headaches and decided why not try to classify them according to
our current criteria. I wanted to bring attention to the issues involved
with pediatric/adolescent headache, review the current epidemiology,
prevalence and impact in a fresh way and discuss the diagnostic issues as
well... I'm delighted by the response and interest this article has
generated and hope that it will bring about renewed interest in the topic."4
Expressing similar thoughts during an MSNBC interview, Robbins commented:
"If you can get the word out to people who are suffering, it’s a positive
thing, and we had some fun along the way."3
* For your reference, here are the proposed IHS criteria for NH:2
A13.7.1 Nummular headache
Previously used terms: Coin-shaped cephalgia
Description: Pain in a small circumscribed area of the head in the
absence of any lesion of the underlying structures.
- Mild to moderate head pain fulfilling criteria B and C:
- Pain is felt exclusively in a rounded or elliptical area typically
2-6 cm in diameter
- Pain is chronic and either continuous or interrupted by spontaneous
remissions lasting weeks to months
- Not attributed to another disorder
There is a slight female preponderance.
Nummular headache is probably a localised terminal branch neuralgia of
the trigeminal nerve. The painful area may be localised in any part of the
head but is usually in the parietal region. The pain remains confined to the
same symptomatic area which does not change in shape or size over time.
Lancinating exacerbations lasting for several seconds or gradually
increasing over 10 minutes to 2 hours may be superimposed on the base-line
pain. During and between symptomatic periods, the affected area may show
variable combinations of hypaesthesia, dysaesthesia, paraesthesia,
tenderness and/or discomfort.
Spontaneous periods of remission have been observed in 38% of patients,
with return to continuous pain after weeks or months.
1 Mohen, Sylvia A., MD; Robbins, Matthew S., MD. "Harry Potter
and Nummular Headache." Headache 2012;4?:323-324
2 Headache Classification Subcommittee of the International
Headache Society. "The International Classification of Headache Disorders
2nd Edition, 1st Revision." Cephalalgia 2005;25:460-465.
3 Carroll, Linda. "Harry
Potter's headache finally diagnosed." MSNBC.com. February 6, 2012.
4 Sheftell, Fred, MD; Steiner, Timothy J., MB, PhD; Hallie
Thomas. “Harry Potter and the Curse of Headache.” Headache 2007;47:911-916.
5 Interview. Teri Robert with Dr. Fred Sheftell. July 1, 2007.
Medical review by
John Claude Krusz, PhD, MD
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© Teri Robert, 2012. Last updated January 17,