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Primary Stabbing Headache in Children and Adolescents

To the Editor: Primary stabbing headache (PSH) is a type of headache disorder characterized by transient, sharp, stabbing pain within a localized area of the scalp, lasting only for a few seconds. Although the prevalence of PSH has been reported to range from 2.5% to 4.2% [1, 2], epidemiological data on PSH are still insufficient. In our retrospective single-center study, 6 eligible individuals [1.5% 4 females and 2 males; mean age, 11 y and 8 mo (range, 8–14 y)] were observed among 400 patients with a profile of migraine (n = 353) and tension-type headaches (n = 162) with compounding conditions. Diagnosis of PSH was based on the International Classification of Headache Disorders, Third Edition (ICHD-3).

All patients had migraine or tension-type headache complications, though it has been previously reported that children/adolescent PSH often occurs alone as opposed to adult PSH [3]. Stabs were located in various sites in the cranium, but mostly in the temple (n = 5). The intensity of stabs varied. None of our cases with PSH required drug therapy, although the efficacy of drug therapy has been reported in children with PSH [1, 4].

Explaining that PSH symptoms are also a type of primary headache, that medication is only needed if the headaches are frequent, and that these headaches usually improve in a short time, helped to reduce anxiety and medication use. This study suggests that patient counseling can help patients accurately determine their own need for acute care medications, which can ultimately lead to less frequent headaches.

In conclusion, PSH in children was similar to that in adults in that they were more common in females and more often associated with migraine [3], but differed from adults in that the pain was more often located outside the trigeminal region. Future studies with long-term follow-up of children/adolescent with PSH are needed to establish the natural course.


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Correspondence to Yu Ishida.

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Takeshita, M., Ishida, Y., Kano, K. et al. Primary Stabbing Headache in Children and Adolescents. Indian J Pediatr 88, 1160 (2021).

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