New daily persistent headache

Abstract

The entity of new daily persistent headache is a recognized form of chronic daily headache with a unique clinical presentation. This review will discuss the clinical characteristics, triggering factors, possible underlying pathogenesis and treatment options for this syndrome. It will also discuss the issues with the current International Classification of Headache Disorders criteria for new daily persistent headache and suggest revised criteria. The medical literature relating to new daily persistent headache is scant so most of what is presented is a personal view by the author who has extensive clinical experience with this syndrome. There is recent interest in the possible role of tumor necrosis factor α in new daily persistent headache pathogenesis and how a history of cervical spine hypermobility may be a needed predisposing physical characteristic for the development of this condition. New daily persistent headache is a recognized form of primary headache. It is unique in its presentation and course. Many new daily persistent headache patients can state the exact date their headache began. New daily persistent headache is marked by a continuous daily head pain of varying intensity, which can be associated with migrainous symptoms. At present, prognosis for new daily persistent headache is recognized as poor with very few available effective treatment options. The current International Classification of Headache Disorders 2 criteria for new daily persistent headache is inadequate and needs to be revised to capture a significant number of patients with this condition that would not meet the current published criteria.