Ice Pick Headache (Ophthalmodynia Periodica)

An ice pick headache is a sudden, stabbing head pain or series of pains that may feel like being stabbed in the head or eye by a sharp object like an ice pick. A fairly rare effect, it seems to develop out of nowhere and lasts a few seconds.

What Causes It?

The International Classification of Headache Disorders considers ice pick headache to be a “primary stabbing headache,” possibly caused by transient disturbances in the brain’s pain-controlling processes. When the pain affects the eyes, it’s referred to as ophthalmodynia periodica

What Are the Symptoms?

As the name suggests, ice pick headache feels like short, sharp strikes to the head. Common symptoms include:

  • Pain that lasts between 3 and 120 seconds at a time
  • Stabbing pain on top, front, or sides of the head
  • Can occur dozens of times a day
  • May cause nausea and dizziness for a small subset of people

How Is It Diagnosed?

In order to diagnose an ice pick headache, the healthcare professional will consider a patient’s medical history and may conduct lab tests and imaging to first rule out other potential head pain conditions, such as cluster headache or trigeminal neuralgia. Cranial autonomic symptoms such as excessive tearing, red eyes/face, or runny, stuffy nose would eliminate a diagnosis of ice pick headache. 

How Is It Treated?

An ice pick headache will typically disappear on its own within a few days. Until it does, patients are advised to follow typical strategies for headache relief, including:

  • Getting plenty of rest in a dark and cool room
  • Avoiding stressful environments or situations, and following meditation practices or low-impact physical activities to help decrease stress
  • Staying well-nourished and well-hydrated

In rare instances where ice pick headache lingers, medication can help — for example, indomethacin, a non-steroidal anti-inflammatory drug, is one of the best-studied treatments for this condition. Melatonin may be recommended to encourage good sleep.

Is It Preventable?

Preventive strategies to help lower the risk of ice pick headache and other head pain disorders include:

  • Eating a well-balanced diet and not skipping meals
  • Maintaining good quality of sleep
  • Managing stress
  • Mindful consumption of caffeine, alcohol, and pain medication

What Causes It?

The International Classification of Headache Disorders considers ice pick headache to be a “primary stabbing headache,” possibly caused by transient disturbances in the brain’s pain-controlling processes. When the pain affects the eyes, it’s referred to as ophthalmodynia periodica

What Are the Symptoms?

As the name suggests, ice pick headache feels like short, sharp strikes to the head. Common symptoms include:

  • Pain that lasts between 3 and 120 seconds at a time
  • Stabbing pain on top, front, or sides of the head
  • Can occur dozens of times a day
  • May cause nausea and dizziness for a small subset of people

How Is It Diagnosed?

In order to diagnose an ice pick headache, the healthcare professional will consider a patient’s medical history and may conduct lab tests and imaging to first rule out other potential head pain conditions, such as cluster headache or trigeminal neuralgia. Cranial autonomic symptoms such as excessive tearing, red eyes/face, or runny, stuffy nose would eliminate a diagnosis of ice pick headache. 

How Is It Treated?

An ice pick headache will typically disappear on its own within a few days. Until it does, patients are advised to follow typical strategies for headache relief, including:

  • Getting plenty of rest in a dark and cool room
  • Avoiding stressful environments or situations, and following meditation practices or low-impact physical activities to help decrease stress
  • Staying well-nourished and well-hydrated

In rare instances where ice pick headache lingers, medication can help — for example, indomethacin, a non-steroidal anti-inflammatory drug, is one of the best-studied treatments for this condition. Melatonin may be recommended to encourage good sleep.

Is It Preventable?

Preventive strategies to help lower the risk of ice pick headache and other head pain disorders include:

  • Eating a well-balanced diet and not skipping meals
  • Maintaining good quality of sleep
  • Managing stress
  • Mindful consumption of caffeine, alcohol, and pain medication
Sources

Sources

  1. The Journal of Headache and Pain. Field Testing Primary Stabbing Headache Criteria According to the 3rd Beta Edition of International Classification of Headache Disorders: A Clinic-Based Study. Lee, Minwoo et al. https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-016-0615-z
  2. American Migraine Foundation. Ice Pick Headaches (Ophthalmodynia Periodica).  https://americanmigrainefoundation.org/resource-library/ice-pick-headaches/
  3. NIH/National Library of Medicine. Current Pain and Headache Reports: Ice Pick Headache. Chua A.; Nahas, S. https://pubmed.ncbi.nlm.nih.gov/27038969/
  4. The Journal of Headache and Pain. Focus on Therapy of Primary Stabbing Headache. Ferrante, Enrico, et al. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3452291/
  5. Cleveland Clinic. Ice Pick Headache: Causes, Symptoms, Treatment & Prevention https://my.clevelandclinic.org/health/diseases/21916-ice-pick-headache

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