Approximately 50% of patients have an identifiable trigger to NDPH. Stress may be a trigger in some patients. Infection, particularly viral, is often cited as a trigger. In one study, Epstein-Barr virus was implicated as an initiating culprit. Exposure to certain toxins may also precede the onset of NDPH. Surgical procedures have occasionally triggered the onset of NDPH. Head injury, even when mild, may be an initial event. Cervical trauma or other pathology, particularly in those who have thin necks with cervical hyper mobility, may initiate the onset of NDPH.
Several studies have evaluated long-term outcomes. One study revealed that, after two years with NDPH, about 25% of the patients were free of headache, and 66% had at least a 50% or greater reduction in headaches over time, while 15% remitted; median time to remission was 21 months. 8% had a cyclic form, with a relapsing-remitting pattern. A small study of children and adolescents discovered that 8 out of 28 patients were free of headache within one to two years, while most (20) continued to suffer long-term from head pain.
NDPH is an important category of headache, as it is often difficult to treat, and results in considerable disability. It is unique in that over 50% of patients have an identifiable trigger, although these range from infection to surgery to head trauma. We are beginning to identify the pathophysiology that leads to NDPH. Treatment of NDPH is scattershot and varied at present; further studies will undoubtedly lead to more effective therapies.
Having been treated for NDPH over the last 2 years, has been exhausting and painful journey. From trying a basket of different drugs, to trying TPI, IMS, botox injections, spine specialists, Psychologists, naturalpathic Dr’s, acupuncture, massage, and NUCA chiropractic treatment. I am no further ahead than when I started, other than knowing what does not work. Living in Canada really limits my access to drugs and trials. My wife will probably be able to out talk most Dr’s about NDPH here in Canada by all the medical research papers, medical journals, blogs, that she has read. Dr’s that are on the leading edge of understanding what this debilitating disease is and how to combat it, all seem to practice in the USA. This disease effects every one in my house hold, not just me. Being in chronic pain changes how you deal with life and its day to day stresses. Every time I am in to see my neurologist he keeps saying that we are at the end on the road for treatment ideas. I am shocked that there is not more funding being put to towards research and trials in Canada or the world for that matter. The headache clinic in Calgary ( CHAMP ) has giving me tools to help with my change in lifestyle, which has not been easy. It has a great bunch of counselors , occupational therapists and Dr’s. The up and down weight from the drugs, the awful side affects of coming off of the drugs, cutting out all processed food, cut down on sodium, and the easiest out of all of this was quitting smoking! I have almost accepted the fact that I may have this for the rest of my life, but have NOT stopped looking for treatment ideas that are available in Canada.
Hi Shayne,
I’ve been diagnosed with NDPH in 2009. I live in Montreal, Canada. Here’s my email : joseegaudreault@gmail.com
If you ever want to discuss this debilitating experience, treatments, ups and downs, doctors mentionning again and again the end of the road concerning treatments….
Dr. Eliz. Leroux happens to be an excellent headache doc, is in Montreal…….
I’ve been waiting for 2 years for appointment with her 🙁
Hi Shayne,
were you able to try IV therapy with methylprednisolone? I’m interested in trying this treatment but don’t know of neurologists in Vancouver who do this, or the rest of Canada.