Abstract
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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