new daily persistent headaches
New Daily Persistent Headaches (NPDH)
New Daily Persistent Headache is yet another type of chronic headache. How can you tell if you are experiencing New Daily Persistent Headache? Usually NPDH begins with a sudden onset – one day you are fine and the next you get a headache that never goes away. New Daily Persistent Headache is thought to occur in approximately 1.7% of the population among adults. NPDH also seems to appear more frequently in young patients, either children or women in their 20’s an 30’s, and men in their 50’s. This condition is very difficult to treat effectively and some people may endure constant headache for years despite treatment.
Here are the common symptoms:
- You have headaches more than fifteen times per month
- Your headaches develop over the course of three days or less
- Pain is typically felt on both sides of the head
- The sensation of pain is usually like that of a tension headache – a constant sensation of pressure
- The level of pain can range from mild to moderate
- The level of pain is not made worse by exercise or routine physical activity
- Other symptoms like mild nausea and sensitivity to light may also exist.
- There is no evidence that the pain is caused by physical abnormalities or another diagnosable condition.
However, these symptoms are not enough to diagnose NPDH. You must also have these symptoms daily, without any sign of improvement for three months or more. Additionally, one must not experience more than one of the following symptoms – mild nausea, sensitivity to light, or sensitivity to noise – not all three and the nausea must not be severe. Essentially, these requirements rule out people with a past history of chronic tension headaches or migraines.
What Triggers New Daily Persistent Headache?
No one knows for sure. Sometimes NPDH appears to be triggered by infections, extracranial surgery, or stress. There also appears to possibly be a link between NPDH and hypothyroidism, hypertension, alcohol consumption, overusing pain medications, and caffeine. Children will frequently have NPDH triggered by extracranial surgery, febrile illness, or head trauma.
Of all triggers, infection such as that caused by the Epstein virus is thought to be the most significant. The root cause is thought to be the body’s response to infection or stress, not the infection itself.
Treating New Daily Persistent Headaches
Typically treatment for NPDH does not vary that much from typical migraine treatment protocols including abortive medication (medication that will stop a headache as it develops, not just mask pain.)
Some instances of NPDH will go away on their own after a period of time whereas other may require constant treatment.
Reference: “New Daily Persistent Headache in Children and Adults,” by Kenneth J. Mack MD, PhD Current Pain and Headache Reports 2009, 13: 47-51.
