scholarly journals Features and Management of New Daily Persistent Headache in Developmental-Age Patients

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 385
Author(s):  
Laura Papetti ◽  
Giorgia Sforza ◽  
Samuela Tarantino ◽  
Romina Moavero ◽  
Claudia Ruscitto ◽  
...  

Introduction. Our aim was to investigate the clinical features of primary new daily persistent headache (NDPH) in a cohort of paediatric patients. Methods. We reviewed the data of patients with persistent daily headache, attending the Headache Centre of Bambino Gesù Children from the January 2009. The ICHD-III criteria were used for diagnosis. Statistical analysis was conducted to study possible correlations between NDPH and population features (age and sex), NDPH and headache qualitative features, and NDPH and response to pharmacological therapies. Results. We included 46 subjects with NDPH. The features of pain more closely resembled those of migraine than to those of tension-type headache (62 vs. 38%). The NDPH patients showed nausea and vomiting less frequently than migraine ones (28.6 vs. 48.2%, p < 0.01). A total of 75% of NDPH patients experienced an onset of the symptoms in the winter months (November to February) (p < 0.01). NDPH was less common in very young children under 10 years of age. Almost 58% of NDPH patients received pharmacological therapy and the most used drug was amitriptyline. A reduction of attacks by at least 50% in a month was detected in 30.6% of patients. Conclusions. NDPH can be very disabling and correlates with seasonal factors. Although long term pharmacological therapy is recommended, considering the long duration that this headache can have, there are no data supporting the treatment choice.

Cephalalgia ◽  
2021 ◽  
pp. 033310242110444
Author(s):  
Rhannon Lobo ◽  
Mu Wang ◽  
Sean Lobo ◽  
Anish Bahra

New daily persistent headache is described as an enigmatic condition with daily headache from onset. It has posed challenges diagnostically and therapeutically. Methods: We conducted a study of patients referred to headache services based in Central and North-East London, United Kingdom, meeting the International Classificaiton of Headache Disorders – 3 criteria for New daily persistent headache. Information on demographics, phenotype and treatment responses were collected. The syndrome of the daily headache was also classified according any other ICHD-3-defined syndrome. Results: Of 162 patients, females comprised 68.5% with median age of onset 35 years. The daily headache experienced was chronic migraine in 89.7% and tension-type headache in 8.8%. Thunderclap-onset New daily persistent headache occurred in 14.8%. More than one headache syndrome was experienced in 15.4%, including cough, hypnic, sexual and stabbing headache. All aura types were experienced, most commonly brainstem aura in 39%. Prior headache was reported 53.7%. A persisting sub-form was present in 51.2%, relapsing remitting in 12.3% and 14.0% reported improvement; 19.8% were lost to follow-up. Only 11.1% reported an antecedent trigger. The most common premorbid disorders were psychiatric in 35.7%. A fifth improved on preventative medication, most commonly amitriptyline, propranolol and topiramate. Conclusion: Our cohort of New daily persistent headache is consistent with a mode of onset of migraine and tension-type headache which occurs in predisposed individuals.


2003 ◽  
Vol 61 (2B) ◽  
pp. 364-367 ◽  
Author(s):  
Abouch Valenty Krymchantowski

Chronic daily headache (CDH) refers to a group of non-paroxysmal daily or near-daily headaches with peculiar characteristics that are highly prevalent in populations of neurological clinics and not uncommon among non-patient populations. Most of the patients with CDH had, as primary diagnosis, episodic migraine, which, with the time, presented a progressive frequency, pattern modification and loss of specific migraine characteristics. Other CDH patients had chronic tension-type headache, new daily persistent headache and hemicrania continua, which evolved thru the time to the daily or near-daily presentation. The objective of this study was to determine the primary headache diagnosis among a population of chronic daily headache patients attending a tertiary center for headache treatment. During a 5-year period 651 consecutive chronic daily headache patients attending a private subspecialty center were studied prospectively. The criteria adopted were those proposed by Silberstein et al (1994, revised 1996). Five hundred seventy four patients (88.1%) had episodic migraine as primary headache before turning into daily presentation, 52 (8%) had chronic tension-type headache, 14 (2.2%) had hemicrania continua and 11 patients (1.7%) had new daily persistent headache. CDH is quite frequent in patients from clinic-based studies suggesting a high degree of disability. Emphasis on education of patients suffering from frequent primary headaches with regard to measures that are able to decrease suffering and disability as well as better medical education directed to more efficient ways to handle these patients are necessary to improve outcome of such a prevalent condition.


Cephalalgia ◽  
2011 ◽  
Vol 31 (15) ◽  
pp. 1561-1569 ◽  
Author(s):  
Kuan-Po Peng ◽  
Jong-Ling Fuh ◽  
Hsiang-Kuo Yuan ◽  
Ben-Chang Shia ◽  
Shuu-Jiun Wang

Introduction: International Classification of Headache Disorders (ICHD-2) criteria for new daily persistent headache (NDPH) require tension-type headache features. Many patients with ‘new-onset persistent’ headache fail to fulfil such criteria due to prominent migrainous features. Subjects and methods: We reviewed all NDPH patients in our headache clinic, using the definition of persistent headache < 3 days after onset for > 3 months. The patients were dichotomised: patients meeting ICHD-2 criteria (NDPH-S) and patients failing to meet ICHD-2 criteria due to prominent migrainous features (NDPH-M). All patients had completed a structured intake form including demographics, headache profiles, Beck Depression Inventory (BDI), Short Form 36 (SF-36) Health Survey, and Migraine Disability Assessment (MIDAS). A telephone interview was conducted for follow-up. Results: A total of 92 NDPH patients were enrolled (59 (64.1%) NDPH-M, 33 (35.9%) NDPH-S). Between the two subgroups, the sociodemographics were indistinguishable, but the patients with NDPH-M had higher headache intensity, BDI scores, MIDAS scores, and lower scores of most SF-36 subscales. After an average of 2 years of follow-up, 57 (66%) had a good outcome (≥ 50% reduction in headache frequency). Cox proportional analysis showed that disease duration ≤ 6 months and NDPH-S diagnosis predicted good outcomes. Conclusion: Migrainous features were common in patients with NDPH. Unlike prior studies, our study showed NDPH-M represented a more severe subgroup with a poorer outcome compared with NDPH-S.


Cephalalgia ◽  
2002 ◽  
Vol 22 (1) ◽  
pp. 66-69 ◽  
Author(s):  
D Li ◽  
TD Rozen

New daily persistent headache (NDPH) is a subtype of chronic daily headache. The literature on NDPH is scant and its true aetiology is unknown. A retrospective chart review was carried out from a computerized database at the Jefferson Headache Centre from August 1997 to May 2000 to identify patients with NDPH using the Silberstein et al. criteria. Forty women and 16 men were identified. Age of onset ranged from 12 to 78 years. The peak age of onset was the second and third decade in women and the fifth decade in men. Eighty-two per cent of patients were able to pinpoint the exact day their headache started. Onset occurred in relation to an infection or flu-like illness in 30%. A prior headache history was found in 38% of patients. A family history of headache was documented in 29%. The duration of daily headache ranged from 1.5 h to 24 h; 79% were continuous. Nausea occurred in 68% of patients, photophobia in 66%, phonophobia in 61%, and lightheadedness in 55%. Laboratory testing and neuroimaging in all patients was normal except for Epstein-Barr virus antibody titres, which were positive in 71% of seven patients tested, representing past infection. NDPH appears to be a female-predominant disorder, marked by a continuous daily headache with associated migrainous symptoms. Over 80% of patients could state the exact date their headache began. One-third of patients developed NDPH with a flu-like illness.


Cephalalgia ◽  
2001 ◽  
Vol 21 (8) ◽  
pp. 830-836 ◽  
Author(s):  
Ishaq Abu-Arafeh

In this study, the causes, predisposing factors and clinical features of chronic daily headache in children and adolescents were studied within the population of patients attending a specialist headache. The International Headache Society's (IHS) criteria for the diagnosis of chronic tension type headache (CTTH) were assessed for their applicability in the paediatric age group. Over a period of three years, demographic and clinical data were collected prospectively on all children who attended the clinic and suffered from daily attacks of headache. One hundred and fifteen children and adolescents (32% of all clinic population) had chronic daily headache, of whom 93 patients (81%) fulfilled the IHS criteria for the diagnosis of CTTH. They were between 3-15 years of age (mean: 11.1, SD: 2.3) and their female to male ratio was 1.2: 1. Around one third of the patients also suffered from migraine (mainly migraine without aura). The headache was described as mild in 60.9%, moderate 36.5% and severe 2.6%. Headache was located at the forehead in 53% or over the whole of the head in 29.6%. Pain was described as ‘just sore’ or dull by 73.9%. During attacks of headache, at least half the patients reported light intolerance, noise intolerance, anorexia or nausea. Thirty-two percent of patients had at least one underlying chronic disease that may have contributed to the pathogenesis of the CTTH. Eleven percent had serious stressful events related to family illnesses and in four patients headaches were triggered by family bereavement. Fourteen percent were investigated with neuroimaging and 22% were referred for clinical psychology assessment and management. In conclusion, CTTH is a common cause of headache in children attending a specialist headache clinic. The clinical features closely match those of adult population and the IHS criteria for the diagnosis of CTTH can be adapted for use in children. Predisposing stressful risk factors, physical or emotional, are present in a large proportion.


Cephalalgia ◽  
1993 ◽  
Vol 13 (12_suppl) ◽  
pp. 72-77 ◽  
Author(s):  
Giorgio Sandrini ◽  
Gian Camillo Manzoni ◽  
Carla Zanferrari ◽  
Giuseppe Nappi

Chronic daily headache (CDH), a heterogeneous group of headaches, includes different forms that occur daily, or almost daily, over a prolonged period of time. The nosography of this group is still a matter of debate, and in the most recent classification of the IHS (1988) only a few types of CDH are included: chronic tension-type headache, coexisting migraine. This study is an epidemiological approach to identifying the clinical features of CDH and the possible factors involved in changing episodic headache in CDH. Ninety CDH outpatients were investigated using a computerized record chart. The main observed forms were: (a) chronic tension-type headache–migraine with interparoxysmal headache, an evolved form of migraine in which a constant low severity headache develops between attacks; (b) transformed migraine, an evolved form of migraine with progressive worsening of the disease which reaches the level of continuous pain with the disappearance of typical migraine attacks. Interval headaches in migraine with interparoxysmal headache partly fulfil the IHS criteria for chronic tension-type headache. Analgesic drug abuse plays a prominent role in inducing CDH and in determining its clinical features.


Cephalalgia ◽  
1993 ◽  
Vol 13 (12_suppl) ◽  
pp. 78-83 ◽  
Author(s):  
Ninan T Mathew

Chronic tension-type headache, which is included in the International Headache Classification, is present in only a minority of patients who present with chronic daily headache. The majority have what is termed transformed migraine, with a history of distinct episodes of migraine in the initial years which progresses into chronic daily headache. These patients with transformed migraine exhibit mixed features of migraine and chronic tension-type headache. Two distinct types of transformed migraine are identifiable, namely those related to excessive intake of medications (drug-induced transformed migraine) and those unrelated to excessive use of medications. The clinical features of transformed migraine and the drug-induced variety are described. The need for revision of the International Classification to include chronic daily headache and the subtypes of transformed migraine is pointed out.


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