Stabbing headache in patients with autoimmune disorders

Stabbing headache is a relatively rare type of chronic “primary” headache with distinctive features withrespect to more common forms of paroxysmal headache, such as cluster headache and trigeminal neuralgia.Drug treatment is empirical because of the lack of knowledge on the pathophysiology of stabbingheadache. We examined 26 patients recruited over 10 years, who met the diagnostic criteria for stabbingheadache. Interestingly, more than half of these patients had autoimmune disorders, including multiplesclerosis, Sjögren’s disease, Systemic Lupus Erythematosus, Behc¸ et’s disease, autoimmune vasculitis, andantiphospholipid antibody syndrome. We speculate that stabbing headache may develop as a result ofneuroinflammation and, at least in some cases, may be an epiphenomenon of focal demyelinating lesionsof the upper or lower brain stem.