New Daily Persistent Headache: a Diagnostic and Therapeutic Odyssey
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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.
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.
KeywordsNew 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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