Stabbing facial pain reminiscent of primary stabbing headache

Ziegeler, Christian; Daneshkhah, Sima; May, Arne

doi:10.1177/0333102420923643

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…2,5,7 Although, there have been other reports with patients with longer durations of each episode (>120 s), as seen in our case series. [24][25][26] We propose, in the future, a change to diagnostic criteria in the ICHD, regarding the frequency and duration of episodes in PSH.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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Objectives This retrospective case series study aimed to investigate the demographic and clinical patterns of primary stabbing headache (PSH). In addition, we tried to identify subgroups of treatment responses in a neurology outpatient consultation at a Portuguese tertiary hospital. Methods Clinical records were retrospectively reviewed and patients meeting the International Classification of Headache Disorders, 3rd edition, criteria for PSH were identified from January 2014 to December 2020. We collected data regarding demographic characteristics, clinical features of the headache, primary headache comorbidities, and information about treatment‐related do PSH. Results Of 1857 patients, 32 (1.7%; mean [SD] age of onset 56 [3.5] years) had the final diagnosis of PSH. Regarding headache characteristics, 20 patients (62.5%) reported episodes of stabbing in fixed locations and 12 (37.5%) in multiple areas; the duration of each attack was between ≤5 s (seven [21.9%]), 5–60 s (20 [62.5%]), and ≥60 s (five [15.6%]). In all, 18 patients (56.3%) had an episodic course (vs. six of 32 [18.8%] an acute course and eight of 32 [25%] a chronic course). In all, 17 patients started medical treatment (53.1%), with total or partial improvement in 10 (58.8%) of them. It was found that patients with pain in fixed locations had a better response to treatment when compared to patients with multiple locations, in a statistically significant way (eight of 11 vs. two of six, p = 0.023). Conclusion In our sample, the mean age of onset of PSH was >50 years and there was a wide range of PSH duration. The duration of each attack (>5 s), the pain in fixed locations, non‐daily episodes of the pain in each attack, and the intermittent course of headache were the most prevalent clinical features. Finally, patients with stabbing in localized areas had a better response to treatment.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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“…In patients with migraine, stabs tend to be localized to areas where migraine attacks frequently occur, and can sometimes occur during migraine attacks. Stabs can involve the face (V2 and/or V3) (16), and facial stabs occurring exclusively within the V2 or V3 dermatome have been reported (23,24). Whether this is a variant of PSH or a new The jolt, which is a sudden movement, can accompany stabs in 38-74% of patients (5,17), which is quite characteristic for PSH.…”

Section: Pain Phenotypementioning

confidence: 99%

Epicranial headache part 1: Primary stabbing headache

2023

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Background/objective Primary stabbing headache is a common but under-recognized primary headache disorder. The objectives of this review were to provide practical information for better understanding and identification of the disease, suggest an algorithm for differential diagnosis, and provide an insight into the pathophysiology of primary stabbing headache hypothesized from its clinical course. Methods This narrative review of primary stabbing headache is based on a literature search and the authors’ clinical reasoning. Result The phenotype of each stab is typically abrupt, ultrashort-lasting (<3 s), focal or multifocal, paroxysms of pain occurring sporadically or in clusters. The diagnosis of primary stabbing headache is clinical; fixed or migrating stabs without background pain or sensory abnormalities and the absence of features suggestive of other disorders (e.g., cranial autonomic symptoms or signs) can aid in the diagnosis of primary stabbing headache. The clinical patterns include monophasic, intermittent, and chronic primary stabbing headache, of which the first two are considered typical. The pathophysiology of primary stabbing headache has not yet been elucidated. In this review, we postulated the mechanism of stabbing headache, based on the pain phenotype and clinical course, and provide a clinical algorithm for the differential diagnosis of primary stabbing headache. Conclusion Knowledge about the typical manifestations and clinical patterns of primary stabbing headache will aid in the proper diagnosis and differential diagnosis. Treatment should be tailored by considering the clinical patterns. Further research is needed to elucidate the pathophysiological mechanisms and optimal treatment of primary stabbing headache.

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“…Reports of orofacial variants of primary headache types other than migraine and cluster headache occur with an unclear prevalence. An orofacial variant of idiopathic stabbing headache (28) has been reported. A very peculiar new entity is constant unilateral facial pain with additional attacks (CUFPA) (5,14) where the constant dull pain is intercepted with distinct non-neuralgic pain attacks of a completely different pain character and without any accompanying symptoms, which lasts 10–30 minutes and occurs between two and 20 times per day.…”

Section: Neuralgiasmentioning

confidence: 99%

Orofacial pain for clinicians: A review of constant and attack-like facial pain syndromes

May,

Benoliel,

Imamura

et al. 2023

Cephalalgia

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Background Primary headache syndromes such as migraine are among the most common neurological syndromes. Chronic facial pain syndromes of non-odontogenic cause are less well known to neurologists despite being highly disabling. Given the pain localization, these patients often consult dentists first who may conduct unnecessary dental interventions even if a dental cause is not identified. Once it becomes clear that dental modalities have no effect on the pain, patients may be referred to another dentist or orofacial pain specialist, and later to a neurologist. Unfortunately, neurologists are also often not familiar with chronic orofacial pain syndromes although they share the neural system, i.e., trigeminal nerve and central processing areas for headache disorders. Conclusion In essence, three broad groups of orofacial pain patients are important for clinicians: (i) Attack-like orofacial pain conditions, which encompass neuralgias of the cranial nerves and less well-known facial variants of primary headache syndromes; (ii) persistent orofacial pain disorders, including neuropathic pain and persistent idiopathic facial/dentoalveolar pain; and (iii) other differential diagnostically relevant orofacial pain conditions encountered by clinicians such as painful temporomandibular disorders, bruxism, sinus pain, dental pain, and others which may interfere (trigger) and overlap with headache. It is rewarding to know and recognize the clinical picture of these facial pain syndromes, given that, just like for headache, an internationally accepted classification system has been published and many of these syndromes can be treated with medications generally used by neurologists for other pain syndromes.

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Stabbing facial pain reminiscent of primary stabbing headache

Cited by 6 publications

References 17 publications

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

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

Epicranial headache part 1: Primary stabbing headache

Orofacial pain for clinicians: A review of constant and attack-like facial pain syndromes

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