primary stabbing headache; ice-pick headache

Epidemiology

• more common among persons with history of migraine

Clinical manifestations

• transient localized stabs of head pain
  • pain may occur anywhere on the head, including the eye
  • the face is generally spared
• duration = seconds, but may be up to 1-2 minutes
• less localized dull pain lasting minutes may follow
• frequency generally < daily, but attacks may occur in series
• periods of exacerbations & remissions common
• no cranial autonomic symptoms (lacrimation or tearing)

Differential diagnosis

• cluster headache
  • duration of 15 minutes to 3 hours
    • mean duration 1 hour
    • pain reaches a peak in about 10-15 min & lasts 45-60 min
  • cranial autonomic symptoms (lacrimation or tearing)

Management

• generally no treatment necessary
• indomethacin may be helpful

More general terms

• headache