This is a peculiar type of headache causing sharp jolts or stabs of head pain lasting for a second or a few seconds. It may occur occasionally or once a day to many times a day. Other names for this headache are icepick headache, and jolts and jabs syndrome.
What is the cause of the stabbing headache?
In most patients, no cause is detected. It is not uncommon for patients with migraine, especially severe migraine, to have this type of pain. If it occurs in isolation with no other associated symptoms, and its location varies between attacks, it is likely of benign type. Even if the location is the same, it is mostly benign.
How common is the stabbing headache syndrome?
In general population it affects about 1% of people, but more than 40% of patients with migraine may have this condition.
How is the stabbing headache diagnosed?
It is mostly diagnosed based upon history and its features. This also helps to distinguish it from some related disorder, such as trigeminal neuralgia where the pain involves the face, and some other headache disorders which have associated symptoms, more than a jab of pain. Most cases do not require any test or imaging. Brain MRI can be considered if the stab is localized to a particular area of the head, but even in those cases no cause is usually discovered. It also should be differentiated from the pain outside the head, e.g., in the back of head and neck from a condition called occipital neuralgia.
How is the stabbing headache treated?
As the pain in this condition does not last long, a painkiller is not a good choice. If it happens rarely, no medicine is needed. Patient needs education and reassurance. It usually is a self-limiting condition, which means that it disappears on its own. In patients with migraine, medicines to control migraine can help. In rare patients with frequent and severe attacks, melatonin, gabapentin, or indomethacin can be tried.
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