title: Stabbing headache in an 8-year-old girl: primary or drug induced headache?
abstract: The occurrence of stabbing headaches in children requires a thorough diagnostic approach that excludes secondary headaches. The organic background should be taken into consideration when alarming symptoms occur, such as a purely 1-sided location, a change in the character of the headache, or possibly a link to physical activity. The current study describes the case of an 8-year-old girl who suffered short-lasting stabbing headache attacks. The headaches with increasing intensity and frequency started 1 month before her hospitalization and were usually preceded by physical activity (dancing, running). The pain, which was located in the right supraorbital region, lasted 1 second and occurred several times during the day. No associated symptoms were observed. In addition, the girl suffered from allergic rhinitis and was on antiallergic treatment (levocetirizine, fluticasone nasal spray). On admission she was in good general condition, and a pediatric and neurologic examination revealed no abnormalities. Her brain MRI was normal. The initial diagnosis was that the patient was suffering from primary stabbing headaches. However, during a follow-up visit 4 months later, a relationship was observed between the cessation of the headache attacks and the discontinuation of an antihistaminic drug. Six months later, the girl remained headache free. In cases involving differential diagnoses of stabbing headaches, it is important to consider the adverse reactions of the drugs used.
authors.affiliation: Department of Pediatric Neurology, Jagiellonian University, Cracow, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Biedroł
authors.forename: Marek
authors.initials: M
authors.lastname: Kaciłski
authors.forename: Barbara
authors.initials: B
authors.lastname: Skowronek-Bała
mesh_terms: D017332:Cetirizine / Q000009:adverse effects; D002648:Child; D005260:Female; D051270:Headache Disorders, Primary / Q000139:chemically induced / Q000209:etiology*; D039563:Histamine H1 Antagonists, Non-Sedating / Q000009:adverse effects; D006801:Humans
chemical_list: D039563:Histamine H1 Antagonists, Non-Sedating; C472067:levocetirizine; D017332:Cetirizine
keywords: child; histamine antagonists; stabbing headache