According to research presented at the 56th Annual Scientific Meeting of the American Headache Society, most cases of new daily persistent headache (NDPH) are associated with a precipitating event such as a flu-like or viral illness.

Robert P. Cowan, MD, Clinical Professor of Neurology and Neurological Sciences at Stanford Hospital and Clinics in California said, “Given this association, the question arises whether NDPH should be more properly classified as a secondary headache disorder similar to post-traumatic headache. Further research is needed to better understand the underlying mechanism of NDPH to guide more effective treatment options.”

Dr. Cowan and colleagues searched Stanford’s medical records for patients admitted between January 2005 and January 2014 with NDPH.

Almost all the patients (92%) had a normal neurologic exam. Approximately 56% of patients had a family history of headache, and 24% had a history of migraine or primary headache disorder. About three-quarters of patients associated an inciting event with the onset of their headache. The inciting event was a preceding infection for 45% of patients, psychologic stress for 10%, trauma for 7% and other inciting event for 14%.

“Our data suggest that NDPH is an uncommon diagnosis, even in the quaternary headache center setting. Of the 3,579 patients seen by the Stanford Headache Clinic since its opening in July 2011, only 35 (1%) met diagnostic criteria for NDPH… and 78 (2%) met criteria for post-traumatic headache, while 2,604 (73%) had a diagnosis of migraine, with the remainder of patients having other primary and secondary headache disorders,” said Dr. Cowan.     Neurology Reviews    September 2014


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