New Therapeutic Approach to Primary Stabbing Headache

Abstract

Primary stabbing headache has been known for several decades. However, the pathophysiology of this disease is not still understood. It is clinically characterized by single episodes or short-lasting series of stabbing pain recurring from once to many times per day in an irregular pattern. The diagnosis is clinical and any other possible cause should be excluded. The therapeutic approach indicates Indomethacin as the first choice of treatment, although case reports describe a therapeutic response to Melatonin, Celecoxib, Nidedipine, Paracetamol and Gabapentin. We describe the case of 5 patients with diagnosis of primary stabbing headache without comorbidity of anxiety or depression that shows a partial response to Indomethacin, but do respond to Benzodiazepines. There is little on the use of Benzodiazepines in primary headaches. They are used in patients with chronic migraine when there is a comorbidity of anxiety and depression. The unexpected efficacy of these molecules in our patients is encouraging and represents a hint to think about using these molecules in other types of primary headaches.