What is new daily persistent headache (NDPH)
New daily persistent headache (NDPH) is a rare, idiopathic, persistent headache with pain becoming continuous and unremitting within 24 hours of onset, present for more than 3 months.
Most patients have a constant headache ranging from mild to severe and bilateral in 89%, and present in any head region. Migraine features are present in over 50%.
The age of onset ranges from 6 to greater than 70 years. Preceding stressful life events are reported in 10%, a flu-like, upper respiratory infection in 14% to 30%, and extracranial surgery in 7% to 12%.
NDPH is a diagnosis of exclusion including
- neoplasms,
- chronic subdural hematoma,
- posttraumatic,
- spontaneous intracranial hypotension,
- idiopathic intracranial hypertension,
- cervical artery dissection,
- reversible cerebral vasoconstriction syndrome,
- cerebral venous thrombosis,
- arteriovenous malformation,
- dural arteriovenous fistula,
- sphenoid sinusitis,
- chronic meningitis,
- postmeningitis,
- Chiari malformation,
- temporal arteritis,
- cervicogenic,
- greater occipital neuralgia.
The headache is treated like the primary headache (migraine or tension type) it most resembles.
