Current Pain and Headache Reports

, Volume 14, Issue 1, pp 41–46 | Cite as

The “Other” Headaches: Primary Cough, Exertion, Sex, and Primary Stabbing Headaches

  • Shuu-Jiun WangEmail author
  • Jong-Ling Fuh


Primary cough headache, primary exertional headache, primary sexual headache, and idiopathic stabbing headache are included in “Other Primary Headaches” (Group 4) in the International Classification of Headache Disorders, 2nd edition (ICHD-II). Headaches provoked by cough, exertion, and sex have different age distributions, but they do share some clinical and pathogenic characteristics. The triggering activities frequently involve Valsalva-like maneuvers, which may explain part of the pathogenesis. Primary stabbing headache is common and characterized by ultra-short stabbing headaches. All these headache disorders respond well to indomethacin, and they are commonly comorbid with migraine except for primary cough headache. Of note, some patients with sexual headache had reversible cerebral vasoconstriction syndromes. Recent large-scaled studies have revealed that the ICHD-II criteria of these four headache disorders cannot be completely fulfilled. Further revisions for the ICHD-II criteria are required based on these results of the evidence-based studies.


Primary cough headache Primary exertional headache Primary stabbing headache Sex-induced headache 



Dr. Shuu-Jiun Wang has served on scientific advisory boards for Pfizer, Inc., Merck Serono, and Allergan, Inc.; has received speaker honoraria from Novartis, GlaxoSmithKline, Pfizer, Inc., Eli Lilly and Company, Janssen-Cilag, Boehringer Ingelheim, Merck Serono, Allergan, Inc., and Wyeth; and receives research support from Merck Serono.

No other potential conflicts of interest relevant to this article were reported.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Neurology, Neurological InstituteTaipei Veterans General Hospital, and National Yang-Ming University School of MedicineTaipeiTaiwan

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