New Daily Persistent Headache (NDPH)

New daily persistent headache is a distinct primary headache syndrome. Primary headache disorders are those for which there is no underlying cause that can be identified. The diagnosis requires that the headache has persisted for more than 3 months, without stopping, and it must not be caused by another medical disorder.

Frequently the person can remember the exact day the NDPH started. The condition can mimic chronic migraine, with light and noise sensitivity and or nausea. Or the headache may be more similar to chronic tension type headache. It can occur at any age, though the average age of onset is 35 years old. It is 2-3 times more common in women, than in men.

Up to 30% of people have had a cold or flu like illness before the start of the headache, about 10% report a stressful life event beforehand, and another 10% have had surgery involving the head (but not neurosurgery). 50% of patients however report no triggering event.

It is important for the migraine specialist, when considering this diagnosis, to make sure that the daily headache is not the result of medication overuse headache. If a person is using pain medications of any kind, including over the counter painkillers, more than 2 days a week, the diagnosis of NDPH cannot be made until this overuse of medication stops.

NDPH does not have any known medicine that cures it. Outcome predictions vary. In some cases the condition resolves itself.  If treatment is required, migraine specialists typically use preventative medications that are used for other headache disorders.  These drugs can be effective and most patients with NDPH are able to achieve an improvement of their headache disorder.

 

References:

New Daily Persistent Headache, Headache, The Journal of Head and Face Pain, 2016, Tepper

Note: Information on this site is not a substitute for professional medical advice.