[Primary stabbing headache: clinical characteristics and response to treatment in a series of 67 patients].
BACKGROUND
Primary stabbing headache (PSH) is defined by the presence of short stabbing pains in the first branch of the trigeminal nerve. According to population-based studies, it is very prevalent, but most cases present stabbing pains with low frequencies and intensities that do not lead the patient to seek medical attention.


OBJECTIVE
We report on 67 cases of PSH attended in the headache service of a tertiary hospital. In the study, the demographic and clinical characteristics are studied, treatment response is reviewed and the features of PSH are compared in terms of whether it was the only headache or was accompanied by others.


METHODS
The study involved 67 patients (51 females and 16 males) diagnosed with PSH between January 2008 and January 2012, of a total number of 1668 (4%) patients attended in the above-mentioned service.


RESULTS
Age at onset: 34.5 ± 16.7 years. Forty-nine cases (73.1%) were associated to another headache, above all migraine. Stabbing pains were often bilateral; 38 (56.7%) patients suffered more than one a day and 11 (16.4%) had more than 10 per day. They lasted less than five seconds in 48 patients (71.6%) and more than 10 seconds in 11 of them (16.4%), with an intensity of 6.8 ± 1.5. The age of onset of PSH was higher if it was the only type of headache than if it was accompanied by others. Twenty-six (38.8%) patients required preventive treatment for the associated headache and 16 (23.8%) took indomethacin, with a similar response in the two groups (73 versus 75%). CONCLUSIONS; PSH is not infrequent in headache clinics, but its phenotype differs from that reported in population-based studies. The characteristics of PSH vary depending on whether it is the only headache or is associated with others. Preventive treatment is often required and patients respond well to it.
Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
María Isabel
MI
Pedraza
Ángel Luis
ÁL
Guerrero-Peral
Sonia
S
Herrero-Velázquez
Patricia
P
Mulero
Johanna
J
Barón
Marina
M
Ruiz
Javier
J
Marco-Llorente
María Nieves
MN
Fernández-Buey
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002648:Child; D015897:Comorbidity; D005260:Female; D051270:Headache Disorders, Primary / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology; D018377:Neurotransmitter Agents / Q000627:therapeutic use; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D018781:Tension-Type Headache / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
D000319:Adrenergic beta-Antagonists; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018377:Neurotransmitter Agents; D007213:Indomethacin