Stabbing Headaches

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)

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One Response to Stabbing Headaches

  1. Janice says:

    Interesting that Gaba was the most popular..

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