Sign Up for a Free Account
  • Updated 02.28.2021
  • Released 09.02.1994
  • Expires For CME 02.28.2024

Primary stabbing headache



Primary stabbing headache consists of idiopathic transient and localized stabs of pain in the head. According to criteria from The International Classification of Headache Disorders, 3rd edition, the sharp stabbing pain is no longer restricted to the first division of the trigeminal nerve. Indomethacin is the main therapeutic option for this type of headache, but melatonin has been shown to be effective in some cases. Primary stabbing headache can occur in isolation, but it is frequently comorbid with another primary headache disorder, such as migraine.

Key points

• Primary stabbing headache is usually a benign self-limited primary headache disorder, consisting of sharp stabs of head pain.

• Age, gender, and whether the headache is comorbid with migraine influence the frequency of primary stabbing headache.

• Imaging is reasonable to exclude secondary causes.

• Indomethacin is the first-line treatment for primary stabbing headache.

• Other therapeutic options include melatonin, gabapentin, and celecoxib.

Historical note and terminology

Primary stabbing headache was first described in 1964, at which time it was called "ophthalmodynia periodica" (11). Since then, brief, sharp, jabbing pains that occur either as single episodes or in repeated flurries have been designated by various terms including: "icepick-like pains," "sharp short-lived head pains," "needle-in-the-eye syndrome," and "jabs and jolts syndrome" (22; 26; 14; 29; 17). The International Classification of Headache Disorders, 3rd edition, uses the term "primary stabbing headache," classified under item 4—other primary headaches.

This is an article preview.
Start a Free Account
to access the full version.

  • Nearly 3,000 illustrations, 
including video clips of 
neurologic disorders.

  • Every article is reviewed by our esteemed Editorial Board for accuracy and currency.

  • Full spectrum of 
neurology in 1,200 
comprehensive articles.

Questions or Comment?

MedLink, LLC

10393 San Diego Mission Rd, Suite 120

San Diego, CA 92108-2134

Toll Free (U.S. + Canada): 800-452-2400

US Number: +1-619-640-4660