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.
Cite this paper
Ngonga, G. K. , Carli, D. , Zavarise, P. , Vollaro, S. and Volta, G. D. (2016). New Therapeutic Approach to Primary Stabbing Headache. Open Access Library Journal, 3, e2529. doi: http://dx.doi.org/10.4236/oalib.1102529.
Headache
Classification Committee of the International Headache Society (IHS) (2013) The
International Classification of Headache
Disorders. Cephalalgia, 33, 629-808.
Ferrante, E., Rossi, P., Tassorelli, C., Lisotto, C. and Nappi, G. (2010) Focus on Therapy of Primary Stabbing
Headache.The Journal of
Headache and Pain, 11, 157-160.
Piovesan, E.J., Zukerman, E., Kowacs, P.A. and Werneck, L.C. (2002) COX-2 Inhibitor
for the Treatment of Idiopathic Stabbing
Headache Secondary to Cerebrovascular Diseases. Cephalalgia, 22, 197-200. http://dx.doi.org/10.1046/j.1468-2982.2002.00346.x
Fusco, C., Pisani, F. and Faienza, C. (2003) Idiopathic Stabbing Headache: Clinical
Characteristic of Children and Adolescents. Brain
& Development, 25, 237-240. http://dx.doi.org/10.1016/S0387-7604(02)00216-4
Knabl, J., Witschi, R., Hosl, K., Reinold, H., Zeilhofer, U.B., et al.
(2008) Reversal of Pathological Pain through Specific Spinal GABAA Receptor Subtypes. Nature, 451, 330-334. http://dx.doi.org/10.1038/nature06493