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Epicranial headache part 1: Primary stabbing headache.

Soonwook Kwon¹, Mi Ji Lee², Manho Kim²

¹Department of Neurology, Inha University Hospital, Incheon, South Korea.

Cephalalgia : an International Journal of Headache

|February 9, 2023

Summary

Primary stabbing headache is a common disorder characterized by brief, sharp pains. Understanding its clinical patterns is key for accurate diagnosis and tailored treatment.

Keywords:

Primary stabbing headache icepick pain idiopathic stabbing headache jabs and jolt syndrome

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Last Updated: Aug 11, 2025

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Area of Science:

Neurology
Headache Medicine

Background:

Primary stabbing headache is a prevalent yet often overlooked primary headache disorder.
This review focuses on enhancing the understanding and identification of this condition.

Purpose of the Study:

To offer practical insights for recognizing primary stabbing headache.
To propose a diagnostic algorithm for differentiating it from other headache types.
To explore potential pathophysiological mechanisms based on clinical presentation.

Main Methods:

A narrative review approach was employed.
Literature search and author clinical reasoning formed the basis of the review.

Main Results:

Primary stabbing headache presents as abrupt, ultrashort (<3s) pain episodes, focal or multifocal.
Clinical diagnosis relies on identifying these stabs without background pain and excluding other disorders.
Typical clinical patterns include monophasic, intermittent, and chronic forms.

Conclusions:

Enhanced knowledge of primary stabbing headache manifestations aids diagnosis and differential diagnosis.
Treatment strategies should align with observed clinical patterns.
Further research is essential to clarify pathophysiology and optimize treatments.