Abstract

Background
Although idiopathic stabbing headache(ISH) seems to be very common primary head- ache with unique clinical features, previous descriptions about ISH were rather confusing. The classi- fication of the International Headache Society emphasized pain location confined to the distribution of the first division of the trigeminal nerve. Other terms describing ISH, such as ice-pick like pain, jab and jolts syndrome, sharp short lived head pain syndrome and ophthalmodynia, had some different clinical features each other. ISH also have been described in conjunction with migraine or cluster headache. However, in clinical practice, ISH occurs more frequently in extra-trigeminal region and is usually not associated with other primary headache syndromes. Methods: From Feb 2001 to August 2001, 1126 consecutive series of patients suffering from headache were examined in our neurology out-patients clinics. Among the patients, 50 patients presented stabbing headache with chief complaints. This sample consisted 21 males and 29 females aged from 12 to 79 years. Inclusion criteria were: (a) manifesting recurrent stabs on the head as a chief complaint, (b) wit- hout other organic causes. Results: The pain was more frequently localized extratrigeminal area(parietal, retroauricular or occipital) (60%), less frequently in the trigeminal area(20%), or both(20%). The orbital region was never affected. Regarding other coexisting forms of headache, only 20% suffered from other types of head- ache(migraine 6%, tension type headache 14%). No body had the associated autonomic features. In most patients(64%), the paroxysms lasted only 1～2s. The maximal frequency of attacks was variable, ranging from several tens to hundreds for one day. ISH was lasted from 1 to 36 days(mean 9.2±6.7 days). Conclusions: Our results show that the clinical features of ISH are somewhat different from previous studies by its location and its lack of association with migraine or cluster. All had benign course. Korean Journal of Headache 3(2):99-104, 2002