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Ice Pick Headache

Abstract

Ice pick headache, also called idiopathic or primary stabbing headache, is a unique headache type associated with ultra-brief stabs of pain, most commonly in the frontal or temporal area. It occurs predominantly in women and is estimated to affect 2–35 % of the population. Unlike other headache types of short duration, such as short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), ice pick headache is not associated with any cranial autonomic symptoms but has been known to occur with nausea, vomiting, photophobia, and dizziness. It exists in two forms: primary and secondary, with examples of secondary causes being herpes zoster meningoencephalitis, meningiomas, stroke, and multiple sclerosis. Ice pick headache is one of the “indomethacin responsive headaches,” but up to 35 % of patients fail to show significant benefit with that treatment. Other treatment options include gabapentin, cyclooxygenase-2 inhibitors, melatonin, and external hand warming.

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Correspondence to Abigail L. Chua.

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Abigail L. Chua and Stephanie Nahas declare that they have no conflict of interest.

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This article is part of the Topical Collection on Uncommon and/or Unusual Headaches and Syndromes

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Chua, A.L., Nahas, S. Ice Pick Headache. Curr Pain Headache Rep 20, 30 (2016). https://doi.org/10.1007/s11916-016-0559-7

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Keywords

  • Ice pick headache
  • Primary stabbing headache
  • Idiopathic stabbing headache
  • Jabs and jolts
  • Indomethacin responsive