Primary Stabbing Headache

A paroxysmal stabbing or icepick-like headache in the multiple nerve dermatomes, especially involving both trigeminal and cervical nerves, has not been fully explained or classified by the International Classification of Headache Disorder, 2nd Edition (ICHD-II). Of patients with acute-onset paroxysmal stabbing headache who had visited the Hallym University Medical Center during the last four years, 28 subjects with a repeated stabbing headache involving multiple dermatomes at the initial presentation or during the course were prospectively enrolled. All patients were neurologically and otologically symptom free. A coincidental involvement of both trigeminal and cervical nerve dermatomes included seven cases. Six cases involved initially the trigeminal and then cervical nerve dermatomes. Five cases showed an involvement of the cervical and then trigeminal nerve dermatomes. The remaining patients involved multiple cervical nerve branches (the lesser occipital, greater occipital and greater auricular). Pain lasted very shortly and a previous history of headache with the same nature was reported in 13 cases. Preceding symptom of an infection and physical and/or mental stress were manifested in seven and six subjects, respectively. All patients showed a self-limited benign course and completely recovered within a few hours to 30 days. Interestingly, a seasonal gradient in occurrence of a stabbing headache was found in this study. A paroxysmal stabbing headache manifested on multiple dermatomes can be explained by the characteristics of pain referral, and may be considered to be a variant of primary stabbing headache or occipital neuralgia.

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Primary Stabbing Headache

Encyclopedia of Pain ◽

10.1007/978-3-642-28753-4_3540 ◽

2013 ◽

pp. 3185-3187

Author(s):

James W. Lance

Keyword(s):

Primary Stabbing Headache ◽

Stabbing Headache

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Field testing primary stabbing headache criteria according to the 3rd beta edition of International Classification of Headache Disorders: a clinic-based study

The Journal of Headache and Pain ◽

10.1186/s10194-016-0615-z ◽

2016 ◽

Vol 17 (1) ◽

Cited By ~ 4

Author(s):

Minwoo Lee ◽

Min Kyung Chu ◽

Juyoung Lee ◽

Jinhyuk Yoo ◽

Hong Ki Song

Keyword(s):

Field Testing ◽

International Classification ◽

Headache Disorders ◽

Primary Stabbing Headache ◽

Stabbing Headache

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Primary Stabbing Headache in Adults and Pediatrics: a Review

Current Pain and Headache Reports ◽

10.1007/s11916-014-0450-3 ◽

2014 ◽

Vol 18 (10) ◽

Cited By ~ 9

Author(s):

Suzanne Hagler ◽

Karen Ballaban-Gil ◽

Matthew S. Robbins

Keyword(s):

Primary Stabbing Headache ◽

Stabbing Headache

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Primary stabbing headache: A new dural sinus stenosis-associated primary headache?

Journal of the Neurological Sciences ◽

10.1016/j.jns.2013.07.1743 ◽

2013 ◽

Vol 333 ◽

pp. e492

Author(s):

A. Ranieri ◽

S. Montella ◽

R. De Simone

Keyword(s):

Primary Headache ◽

Dural Sinus ◽

Primary Stabbing Headache ◽

Sinus Stenosis ◽

Stabbing Headache

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Primary Stabbing Headache

10.1007/springerreference_123563 ◽

2012 ◽

Keyword(s):

Primary Stabbing Headache ◽

Stabbing Headache

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Primary stabbing headache

Oxford Textbook of Headache Syndromes ◽

10.1093/med/9780198724322.003.0023 ◽

2020 ◽

pp. 215-219

Author(s):

Rashmi B. Halker ◽

Esma Dilli ◽

Amaal Starling

Keyword(s):

Treatment Options ◽

Headache Disorder ◽

Primary Stabbing Headache ◽

Drug Of Choice ◽

Prophylactic Drug ◽

Stabbing Headache ◽

Idiopathic Stabbing Headache ◽

The Brain ◽

Cyclooxygenase 2 Inhibitors ◽

Secondary Causes

Primary stabbing headache is a unique headache disorder, also known as idiopathic stabbing headache, ice pick headache, and jabs and jolts syndrome. The headache is described as a sharp, stabbing pain, lasting seconds to minutes, with no associated symptoms, including any autonomic features. It is more common in women by a 3:1 ratio and is comorbid with migraine, with some studies reporting that up to 40% of migraineurs also have primary stabbing headache. Performing magnetic resonance imaging of the brain is reasonable in patients who present with stabbing headache, as there are secondary causes. Meningiomas, hemorrhages, and giant cell arteritis have all been reported to present in this manner. As primary stabbing headache is a benign disorder, infrequent attacks do not require treatment and patients can be counselled accordingly. For more frequent attacks, indomethacin is the prophylactic drug of choice. Other treatment options include melatonin and cyclooxygenase-2 inhibitors.

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