Stabbing headache in a teenager.

CLINICAL HISTORY A 17-year-old adolescent girl was seen with a 4-year history of head pain which, initially, was occasional. After gradually increasing in frequency during the last year, this pain has been occurring daily. She describes a stabbing pain in the left or right temple lasting seconds. She often has multiple recurring pains (pain for seconds, brief remission, recurrent pain, etc) with a total duration from about 5 seconds to 2 minutes occurring one to four times daily. There is also a several-year history of occasional bifrontal throbbing headache associated with nausea and light and noise sensitivity which can last for hours. Her mother also has migraine. Neurologic examination is normal. Questions.— Would you recommend any testing? How common is idiopathic stabbing headache in children and adolescents? What is the possible duration and distribution of the pain? Is there a relationship to migraine? What treatment would you recommend? What is the prognosis?