Pedraza María Isabel, Guerrero-Peral Ángel Luis, Herrero-Velázquez Sonia, Mulero Patricia, Barón Johanna, Ruiz Marina, Marco-Llorente Javier, Fernández-Buey María Nieves
Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España.
Rev Neurol. 2012 Oct 16;55(8):469-74.
Primary stabbing headache (PSH) is defined by the presence of short stabbing pains in the first branch of the trigeminal nerve. According to population-based studies, it is very prevalent, but most cases present stabbing pains with low frequencies and intensities that do not lead the patient to seek medical attention.
We report on 67 cases of PSH attended in the headache service of a tertiary hospital. In the study, the demographic and clinical characteristics are studied, treatment response is reviewed and the features of PSH are compared in terms of whether it was the only headache or was accompanied by others.
The study involved 67 patients (51 females and 16 males) diagnosed with PSH between January 2008 and January 2012, of a total number of 1668 (4%) patients attended in the above-mentioned service.
Age at onset: 34.5 ± 16.7 years. Forty-nine cases (73.1%) were associated to another headache, above all migraine. Stabbing pains were often bilateral; 38 (56.7%) patients suffered more than one a day and 11 (16.4%) had more than 10 per day. They lasted less than five seconds in 48 patients (71.6%) and more than 10 seconds in 11 of them (16.4%), with an intensity of 6.8 ± 1.5. The age of onset of PSH was higher if it was the only type of headache than if it was accompanied by others. Twenty-six (38.8%) patients required preventive treatment for the associated headache and 16 (23.8%) took indomethacin, with a similar response in the two groups (73 versus 75%). CONCLUSIONS; PSH is not infrequent in headache clinics, but its phenotype differs from that reported in population-based studies. The characteristics of PSH vary depending on whether it is the only headache or is associated with others. Preventive treatment is often required and patients respond well to it.
原发性刺痛性头痛（PSH）的定义是三叉神经第一支出现短暂的刺痛。根据基于人群的研究，该病非常普遍，但大多数病例的刺痛频率和强度较低，患者不会因此就医。
我们报告了一家三级医院头痛门诊收治的67例PSH病例。在该研究中，对患者的人口统计学和临床特征进行了研究，回顾了治疗反应，并比较了PSH在单纯性头痛或伴有其他头痛情况下的特征。
该研究纳入了2008年1月至2012年1月期间在上述门诊就诊的1668例患者中的67例（51例女性，16例男性），这些患者被诊断为PSH。
发病年龄：34.5±16.7岁。49例（73.1%）与另一种头痛相关，主要是偏头痛。刺痛通常为双侧性；38例（56.7%）患者每天发作不止一次，11例（16.4%）患者每天发作超过10次。48例患者（71.6%）的刺痛持续时间少于5秒，11例患者（16.4%）的刺痛持续时间超过10秒，强度为6.8±1.5。若PSH为唯一的头痛类型，其发病年龄高于伴有其他头痛的情况。26例（38.8%）患者因相关头痛需要预防性治疗，16例（23.8%）患者服用了吲哚美辛，两组的反应相似（73%对75%）。结论：PSH在头痛门诊并不罕见，但其表型与基于人群的研究报告不同。PSH的特征因是否为唯一头痛或与其他头痛相关而有所不同。通常需要进行预防性治疗，患者对此反应良好。
