Clinical Characteristics of Primary Stabbing Headache (P5.201)

OBJECTIVE: To clarify clinical characteristics of primary stabbing headache. BACKGROUND: Primary stabbing headache (PSH) is characterized by transient, ultrashort stabs of pain on head. The International classification of Headache disorder 3rd edition (ICHD-3) emphasize that PSH is more commonly occurred in patients with migraine and attack frequency is generally low, with one or a few per day. However PSH seems to occur more frequently in patients with TTH and stabs usually occur more than dozens of times per day and repetitively over days. DESIGN/METHODS: To define clinical features of Primary stabbing headache more clearly, we investigated patients presented with stabbing headache. 316 patients suffering from stabbing headache were examined in our headache clinics. Inclusion criteria were: (a) Recurrent stabbing head pain occurring spontaneously as a single stab or series of stab. (b) Patients who suffer from stabbing pain as a chief complaint (c) Without other organic causes. RESULTS: These patients consisted of 184 females and 132 males aged 12 to 86 years (mean age = 51.45 14.08). The pain was more frequently localized extratrigeminal area (retroauricular or occipital) (41.8%), less frequently in the trigeminal area (34.2%), or both (24%). Regarding other headache history, 32.4% suffered from other types of headache (migraine 9.1%, tension type headache 23.9%). Nobody had the associated autonomic features. In most patients (72.8%), the paroxysms lasted only 1-2s. The maximal frequency of attacks during one day was variable, ranging from several tens to hundreds. Stabbing headache was lasted from 1 to 37 days (mean 9±7 days, median 7 days). CONCLUSIONS: These results show that the clinical features of PSH are somewhat different from previous studies. PSH is more commonly occurred in patients with tension type headache than migraine and attack frequency is generally high, with more than several tens per day. Study Supported by: Disclosure: Dr. Lee has nothing to disclose. Dr. Byung-Kun has nothing to disclose.