New Daily Persistent Headache: a Diagnostic and Therapeutic Odyssey

  • Emily J. Riddle
  • Jonathan H. SmithEmail author
Headache (R. Halker Singh, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Headache


Purpose of Review

New daily persistent headache (NDPH) is a rare primary headache disorder, which often has a refractory clinical course. This narrative review seeks to highlight what is known about the development of NDPH, to outline a diagnostic approach to a patient with new daily headache, and to explore management considerations and potential future therapies for patients diagnosed with NDPH.

Recent Findings

Interval work at the level of case series and cohort studies has identified novel triggering factors (e.g., Valsalva), subgroups with unique temporal profiles (e.g., thunderclap onset), psychophysical profiles (e.g., increased pain catastrophizing), and potential treatment options.


The approach to the diagnosis and treatment of NDPH remains individualized, driven by clinical features and challenging in most cases. Earlier identification of patients (e.g., prediction of patients with status migrainosus destined to develop NDPH) may allow for more effective treatment.


New daily persistent headache Status migrainosus Refractory headache Intractable headache Migraine 


Compliance with Ethical Standards

Conflict of Interest

Jonathan H. Smith reports royalties for the articles “Acute treatment of migraine in adults” and “Preventive treatment of migraine in adults” from UpToDate and a speaking fee (January 2019) from AMGEN, outside the submitted work. Emily J. Riddle declares no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeurologyCincinnati Children’s HospitalCincinnatiUSA
  2. 2.Department of NeurologyMayo ClinicScottsdaleUSA

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