New daily persistent headache

Abstract

The new daily persistent headache (NDPH) has been implemented as a separate headache disorder in the International Classification of Headache Disorders in 2004. It is hardly known, although the prevalence is about as high as for cluster headache. The headache is defined by its sudden onset within one day and by the persistent pain from then on without any break. The headache itself is unspecific and often of moderate intensity. The pathophysiology is completely unknown, although a postinfectious aetiology has been discussed. A further typical feature is the very poor efficacy of all therapeutic procedures. Treatment is empiric; intravenous infusions with lidocaine or ketamin seem to have the best although only short lasting efficacy. Botulinumtoxin has been described as efficacious in some cases. Oral drug treatment is almost always without benefit. It is important for the sufferers to receive a correct diagnosis and to learn how to cope with this headache disorder.