Rather new entity is the stabbing headache – primary stabbing headache (PSH) – often in occipital area, happening 2-100 times a day and more occipital (back of head) in location. Treatment is not all what you’d think – its indomethacin, prednisone, gabapentin or tricyclic antidepressants.
Kim, Dong Yeop, et al.
Clinical patterns of primary stabbing headache: a single clinic-based prospective study. The Journal of Headache and Pain 18.1 (2017): 44.
http://link.springer.com/article/10.1186/s10194-017-0749-7
- 65 cases
- Stabbing headaches often described as a jolt
- 69.2% female
- typically presents as one episode up to 40 days average with severity 7/10
- most occipital – 84.6%
- side locked 69.2%
- most range from 2-100 jabs/day
- 72.3% daily
- 73.8% felt as a jolt
- 56.9% persistent
- high relapse rate of jabs
treatments included:
Indomethacin 12.3%
Prednisolone 16.9% – apparently an excellent response which suggested inflammatory origin
Gabapentin 20.0%
Tricyclic antidepressants 9.2%
Comment – not sure how you would differentiate from occipital neuralgia but steroid responsiveness and less jab frequency would suggest the primary stabbing headache (PSH) maillot de foot maillot de foot
Interesting that Gaba was the most popular..