WHAT IS NDPH (NEW DAILY PERSISTENT HEADACHE)?
NDPH (New Daily Persistent Headache) is characterized by a distinct and clearly remembered onset of a continuous daily headache, and it must be present for more than 3 months. Many times, the patient comes into the office and gives the specific date that the headache began. For example, they may say something like “I woke up on August 17th 2008 with a headache and it has been there every day since”. Testing by brain imaging and labs should all be normal and show no cause. This is understandably frustrating for the patient since all testing is typically normal (as it is in migraine and most types of headaches). In general, the pain of NDPH lacks specific characteristic features. It commonly has migraine or tension-type headache features, and often overlapping features of both. It typically fluctuates in intensity but can also be a persistent flat unchanging type of headache. It is defined by it’s abrupt onset and persistence as a daily continuous headache for more than 3 months without any causes identified.
WHAT CAUSES NDPH (NEW DAILY PERSISTENT HEADACHE)?
As mentioned above, there should be no causes identified per the definition of NDPH. If there is a cause identified, than the NDPH diagnosis is changed to the suspected cause found. The most common scenarios in which NDPH begins is in the setting of some nonspecific viral infection such as the common cold, upper respiratory infection, flu, gastroenteritis, or some other unspecified infection. It also commonly presents in the setting of a period of high emotional stress. However, it most commonly presents with nothing new correlating with the timing, and no association with anything at all.
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