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Prophylaxis with melatonin for primary stabbing headache in pediatrics: a case report
Bermúdez, Salazar Mauricio; Rojas, Cerón Christian Andrés & Arana, Muñoz Ronald Santiago
Abstract
Introduction: Primary stabbing headache (or “ice pick headache”)
is an alteration characterized by brief jabs (short stabs of pain, lasting
~3 seconds), which appear spontaneously, irregularly, and affecting
unilaterally or bilaterally. Indomethacin has traditionally been used
as the main therapeutic option. However, this drug is ineffective in a
considerable percentage of patients and can generate multiple adverse
effects that occur at therapeutic doses.
Clinical case: A 7-year-old male patient with primary stabbing headache
of mild to moderate intensity, lasting 3 to 4 seconds, without relevant
history, with normal neurodevelopment, neurological examination and
neuroimaging; no triggers were identified. It was started therapeutic
trial with Coenzyme Q10; however, no improvement in the symptoms
was identified.
Treatment and outcomes: A therapeutic management was carried
out with Melatonin, which led to complete remission of the symptoms;
without adverse effects in the posterior follow-up months.
Clinical and scientific relevance: There is little information regarding
effective and safe treatments for primary stabbing headache in children.
The present case identifies Melatonin as an innovative, effective and safe
therapeutic alternative in the treatment of primary stabbing headache in
children. This is a significant advance in the understanding of primary
stabbing headache in the pediatric population.
Conclusion: Melatonin may be an effective and safe therapeutic option
for the treatment of primary stabbing headache in pediatric patients.
It is necessary to deepen its research, in order to establish its use in a
clinical practice guide.
Keywords
Primary stabbing headache; Melatonin; Children; Case report; Ice-pick headache
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