Primary Stabbing Headache

Curr Neurol Neurosci Rep. 2019 Jun 8;19(7):47. doi: 10.1007/s11910-019-0955-6.

Abstract

Purpose of review: To provide a comprehensive and updated review of the literature on primary stabbing headache.

Recent findings: Changes to the ICHD-3 criteria have resulted in increased sensitivity to capture primary stabbing headache (PSH). According to the ICHD-3, the sharp stabbing pain is no longer restricted to the first division of the trigeminal nerve. Age, gender, and co-morbidities such as migraine seem to influence the prevalence of PSH. Subclassification into monophasic, intermittent, and chronic forms have been proposed in a recent prospective study and may be helpful from a prognostication perspective; however, further studies are required. Secondary etiologies for stabbing headaches are part of the differential diagnosis of primary stabbing headache; therefore, it is reasonable to perform neuroimaging. For severe frequent attacks, indomethacin continues to be considered first line. Other treatment options include COX2 inhibitors and melatonin.

Keywords: Ice pick headache; Idiopathic stabbing headache; Jabs and jolts headache; Primary stabbing headache; Sharp short-lived head pain.

Publication types

  • Review

MeSH terms

  • Comorbidity
  • Diagnosis, Differential
  • Female
  • Headache Disorders, Primary / diagnosis*
  • Headache Disorders, Primary / drug therapy
  • Headache Disorders, Primary / epidemiology
  • Humans
  • Indomethacin
  • Male
  • Melatonin
  • Migraine Disorders / diagnosis
  • Neuroimaging
  • Pain
  • Prevalence
  • Prospective Studies

Substances

  • Melatonin
  • Indomethacin