Gabapentin-Responsive Idiopathic Stabbing Headache

Abstract

Idiopathic stabbing headache (ISH) is defined as the occurrence of short-lasting, painful jabs, restricted to the ophthalmic division of the trigeminal nerve. It is closely related to other forms of headache (such as migraine and tension-type headache) and has been reported among all age groups, including children and adolescents. As pathogenic mechanisms of the disease remain unclear, management decisions are empirical and limited to few options. Classically, indomethacin has been considered the first option, but therapeutic failure occurs in up to 35% of cases. In this setting, we report four patients with young-onset indomethacin-resistant ISH which had good responses to gabapentin and discuss the use of this drug in the presenting situation.

Indomethacin-Responsive Headaches

“…Propranolol has been used to treat exercise [40] and sex headaches [81]. Primary stabbing headaches often do not require treatment, but if treatment is required, then celecoxib [82], nifedipine [83], melatonin [84], and gabapentin [85] can be tried instead of indomethacin. Hypnic headache can be treated with lithium [4] or caffeine [5].…”

Botulinum neurotoxin type-A for primary stabbing headache: an open study

“…Our case series illustrates the excellent results observed in PSH patients after BoNT-A injections. Neither one of the therapeutic options previously reported 7,[9][10][11][12][13] for PSH, showed similar results. We suggested BoNT-A to be included among the therapeutic options for focal, localized PSH.…”

“…Other therapeutic options for PSH not used in our patients include: indomethacin 7 ; nifidipine 10 , cyclooxygenase-2 (COX-2) selective inhibitors 10 and etoricoxib 11 ; gabapentin 12 and melatonin 13 . Our case series illustrates the excellent results observed in PSH patients after BoNT-A injections.…”

Gabapentin for prevention of hypobaric hypoxia-induced headache: Randomized double-blind clinical trial

“…Gabapentin has not been used for HAH prevention so far but it has formerly been used for the prevention and treatment of migraine and other types of headache 6 13 – 17. As HAH is a self-limiting condition and could be relieved after acclimatisation,3 inducing delay in its occurrence might be an appropriate goal in prophylactic therapy.…”