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Childhood primary stabbing headache: A double center study.

Gabriele Monte¹, Laura Papetti¹, Fabiana Ursitti¹

¹Developmental Neurology Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00165 Rome, Italy.

Cephalalgia : an International Journal of Headache

|January 12, 2024

Summary

Childhood primary stabbing headache (PSH) characteristics vary, with many experiencing longer stab durations than current criteria allow. Associated migraine and episodic syndromes suggest a potential common link requiring further study.

Keywords:

Children migraine primary headache primary stabbing headache

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Area of Science:

Neurology
Pediatrics
Headache Medicine

Background:

Primary stabbing headache (PSH) is an idiopathic disorder causing brief, localized head pain.
The study evaluated childhood PSH characteristics against the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria.
Investigated associations between PSH, migraine, and episodic syndromes in children.

Purpose of the Study:

To characterize childhood primary stabbing headache (PSH).
To assess the suitability of ICHD-3 criteria for diagnosing PSH in children.
To explore the relationship between PSH, migraine, and episodic syndromes in pediatric patients.

Main Methods:

Retrospective study of 60 pediatric patients diagnosed with PSH at two headache clinics (2016-2022).
Standardized headache history and neurological examinations were performed.
Diagnosis of PSH was based on ICHD-3 criteria.

Main Results:

Median age at onset was 8 years, with stab durations varying up to 30 minutes.
Over 78% had a family history of primary headaches, particularly migraine.
38% of patients met probable PSH criteria due to stab duration exceeding 3 seconds, and 43% had associated episodic syndromes.

Conclusions:

Childhood PSH exhibits diverse features, with stab durations often exceeding current ICHD-3 criteria, suggesting a need for diagnostic adjustments.
A high prevalence of associated migraine and episodic syndromes indicates a potential shared pathophysiology.
PSH and migraine may represent a spectrum of the same disorder, warranting further investigation with larger, longitudinal studies.