Time to retire ‘New daily persistent headache’: Mode of onset of chronic migraine and tension-type headache

Cephalalgia ◽  
2021 ◽  
pp. 033310242110444
Author(s):  
Rhannon Lobo ◽  
Mu Wang ◽  
Sean Lobo ◽  
Anish Bahra
Keyword(s):  
Chronic Migraine ◽  
Age Of Onset ◽  
Tension Type Headache ◽  
New Daily Persistent Headache ◽  
North East ◽  
Daily Headache ◽  
Stabbing Headache ◽  
Type Headache ◽  
Persistent Headache ◽  
Lost To Follow Up

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.

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 ◽  
...  
Keyword(s):  
Tension Type Headache ◽  
Pharmacological Therapy ◽  
New Daily Persistent Headache ◽  
Headache Centre ◽  
Long Duration ◽  
Seasonal Factors ◽  
Developmental Age ◽  
Daily Headache ◽  
Type Headache ◽  
Persistent Headache

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.

scholarly journals Integrative East–West Medicine Intervention for Chronic Daily Headache: A Case Report and Care Perspective

2020 ◽  
Vol 9 ◽  
pp. 216495612090581
Author(s):  
Justin G Laube ◽  
Thais Salles Araujo ◽  
Lawrence B Taw
Keyword(s):  
Chronic Migraine ◽  
Chronic Daily Headache ◽  
Medication Overuse ◽  
Trigger Point ◽  
Tension Type Headache ◽  
Contributing Factors ◽  
Chronic Tension Type Headache ◽  
Daily Headache ◽  
Type Headache ◽  
East West

Chronic daily headache is a group of headache syndromes including most commonly chronic migraine and chronic tension-type headache, which often overlap, are complicated by medication overuse and are disabling, costly, and variable responsive to western pharmacotherapeutic interventions. There is growing research and awareness of integrative health approaches and therapies to address patients with chronic headache, yet limited examples of how to deliver this approach. This article reviews a commonly seen challenging case of a patient with overlapping chronic migraine and chronic tension-type headache complicated by medication overuse managed with an integrative east–west medicine intervention. This included person-centered biopsychosocial history taking, traditional Chinese medicine informed acupuncture, trigger point injections, and contributing factors modifications. A narrative review of the literature is presented to demonstrate an evidence-informed rationale for incorporating nonpharmacologic approaches to effectively help reduce the symptom burden of this patient population.

scholarly journals Primary headache diagnosis among chronic daily headache patients

2003 ◽  
Vol 61 (2B) ◽  
pp. 364-367 ◽  
Author(s):  
Abouch Valenty Krymchantowski
Keyword(s):  
Chronic Daily Headache ◽  
Primary Headache ◽  
Episodic Migraine ◽  
Tension Type Headache ◽  
Hemicrania Continua ◽  
Headache Diagnosis ◽  
Daily Headache ◽  
Type Headache ◽  
Persistent Headache ◽  
Headache Patients

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.

New daily persistent headache: Should migrainous features be incorporated?

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
Keyword(s):  
Short Form ◽  
Tension Type Headache ◽  
New Daily Persistent Headache ◽  
Sf 36 ◽  
Headache Clinic ◽  
Type Headache ◽  
Definition Of ◽  
Persistent Headache

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.

The Clinical Characteristics of New Daily Persistent Headache

Cephalalgia ◽  
2002 ◽  
Vol 22 (1) ◽  
pp. 66-69 ◽  
Author(s):  
D Li ◽  
TD Rozen
Keyword(s):  
Age Of Onset ◽  
Retrospective Chart Review ◽  
New Daily Persistent Headache ◽  
Past Infection ◽  
Barr Virus ◽  
Headache Centre ◽  
Antibody Titres ◽  
Daily Headache ◽  
Epstein Barr ◽  
Persistent Headache

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.

Neurovascular Headache and A Midbrain Vascular Malformation: Evidence for A Role of the Brainstem in Chronic Migraine

Cephalalgia ◽  
2002 ◽  
Vol 22 (2) ◽  
pp. 107-111 ◽  
Author(s):  
PJ Goadsby
Keyword(s):  
Chronic Migraine ◽  
Functional Imaging ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Transformed Migraine ◽  
Positron Emission ◽  
Neurovascular Headache ◽  
Daily Headache ◽  
Type Headache

Migraine is a common, disabling form of primary headache that has been linked by functional imaging studies to activation in the rostral brainstem. In specialty clinics migraine is most commonly seen in association with frequent less feature full headache that has been called transformed migraine or more recently termed chronic migraine. A patient is described with frequent migraine, 3 days per week, and less feature full headaches on other days. The patient has a cavernoma in the midbrain that has bled. She was previously headache free and now has contralateral daily headache. The patient supports the functional imaging observations from positron emission tomography (PET) that the rostral brainstem is pivotal in migraine pathophysiology, particularly the contralateral midbrain periaqueductal grey matter. Moreover, the patient's lesion provides biologically plausible support that a single entity causes her clinical presentation: chronic migraine, not two-disorders, migraine and tension-type headache.

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