Primary stabbing headache

What is primary stabbing headache

Primary stabbing headache is an idiopathic disorder with transient and localized stabs of pain lasting 3 seconds or less 80% of the time (rarely 10 to 120 seconds) anywhere on the head, unilateral > bilateral of mild to severe intensity occurring in children and adults.

One study found 38% with single stabs, 30% with a series of stabs, and 32% with both.

This disorder is comorbid with migraine as well as tension-type headache, hemicrania continua, and primary cough headache. 

Secondary causes of short stabbing headaches include herpetic meningoencephalitis, intracranial meningioma, pituitary tumors, acute thalamic hemorrhage, temporal arteritis (age >50 years), multiple sclerosis, systemic lupus erythematosus, Sjogren’s, Behçet’s, vasculitis, Lyme, and antiphospholipid antibody syndrome. 

Possible treatments include indomethacin 75 to 150 mg daily, celecoxib 100 mg bid, melatonin 3 to 12 mg daily, gabapentin, and botulinum toxin A injections as well as amitriptyline in children.


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