Primary stabbing headache in children and adolescents

Abstract

Aim To examine the characteristics of primary stabbing headache (PSH) in typically developing children and adolescents. Method In this prospective non‐interventional hospital‐based study, we examined 42 eligible individuals (24 females, 18 males; 26 white; mean age 12y 1mo, range 6y–16y 1mo) with spontaneous transient stabs. A headache focused history and/or a headache diary was obtained from each patient. All patients had normal neurological examination. Diagnosis of primary headache was based on the International Classification of Headache Disorders, Third Edition (ICHD‐3) beta version. Results Duration of stabs ranged from a few seconds to up to 10 minutes. Stabs were located in a variety of sites on the cranium but mostly in the extra‐trigeminal regions (n=28). Intensity of stabs varied from moderate (n=4) to severe (n=38). The frequency of the stabs ranged from daily to monthly. There were up to 50 stabs per headache attack. Stabs among our patients occurred independently from those caused by other primary headache types. Accompanying symptoms during stabs were reported by eight patients. Family history of primary headaches was identified (n=17). Familial transmission of PSH was recognized among two patients. All patients had normal brain magnetic resonance imaging. Interpretation The presentation and nature of PSH in children and adolescents varies widely. PSH in children may be a different entity to that in adults, and there is a need for further research to support changes in the ICHD‐3 criteria for PSH in children and adolescents. What this paper adds Presentation of childhood primary stabbing headache (PSH) varies widely. Duration of PSH could last from a few seconds up to 10 minutes.

Clinical pattern and response to treatment of primary stabbing headache: Retrospective case series study from a Portuguese tertiary hospital

“…However, it is thought that the frequency of attacks is variable but, in general, they are low, with erratic intervals from daily to monthly. 7,22 In the largest population study for PSH, it was reported that 68% had stabbing headache frequencies of <1 stab/day. 23 We hypothesize that these groups with infrequent attacks could have a better chance of spontaneous remission of PSH, but future studies are needed to confirm.…”

Primary stabbing headache: the need for a definition for children and adolescents

“…Thus, the rare occurrence of PSH in children makes the study by Ahmed et al timely and useful. 3 The authors report on 42 children with a potential diagnosis of PSH and demonstrate the difficulties in assessment of clinical features and duration of attacks in particular: seven children reported attacks lasting less than 3 seconds, eight had attacks of more than 3 seconds and less than 2 minutes, and 27 patients had attacks lasting between 2 and 10 minutes. Until there are specific diagnostic tests for PSH, and indeed all other types of headache, clinical criteria will continue to be needed.…”

“…Also, a category of probable PSH was introduced in the ICHD‐3 beta and ICHD‐3 which there is no requirement for a definite duration of the stabs if other conditions are fulfilled. Specific criteria for the diagnosis of PSH in children are lacking and studies on larger numbers of children and adolescents with PSH will help in making the diagnosis clearer …”

“…Specific criteria for the diagnosis of PSH in children are lacking and studies on larger numbers of children and adolescents with PSH will help in making the diagnosis clearer. 3,4 Management of children with PSH depends on the frequency of attacks and their impact on the child's quality of life and education. Making the correct diagnosis helps the child and the family understand and deal with the condition.…”

Primary Stabbing Headache in Children and Adolescents

“…To the Editor: Primary stabbing headache (PSH) is a type of headache disorder characterized by transient, sharp, stabbing pain within a localized area of the scalp, lasting only for a few seconds. Although the prevalence of PSH has been reported to range from 2.5% to 4.2% [1,2], epidemiological data on PSH are still insufficient. In our retrospective single-center study, 6 eligible individuals [1.5% 4 females and 2 males; mean age, 11 y and 8 mo (range, 8-14 y)] were observed among 400 patients with a profile of migraine (n = 353) and tension-type headaches (n = 162) with compounding conditions.…”