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. 2010 Apr 27;74(17):1358-64.
doi: 10.1212/WNL.0b013e3181dad5de.

Clinical and prognostic subforms of new daily-persistent headache

M S Robbins  1 , B M Grosberg, U Napchan, S C Crystal, R B Lipton
Affiliations

Clinical and prognostic subforms of new daily-persistent headache

M S Robbins et al. Neurology. .

Erratum in

  • Neurology. 2010 Nov 2;75(18):1660

Abstract

Background: According to the International Classification of Headache Disorders (ICHD)-2, primary daily headaches unremitting from onset are classified as new daily-persistent headache (NDPH) only if migraine features are absent. When migraine features are present, classification is problematic.

Methods: We developed a revised NDPH definition not excluding migraine features (NDPH-R), and applied it to consecutive patients seen at the Montefiore Headache Center. We divided this group into patients meeting ICHD-2 criteria (NDPH-ICHD) and those with too many migraine features for ICHD-2 (NDPH-mf). We compared clinical and demographic features in these groups, identifying 3 prognostic subgroups: persisting, remitting, and relapsing-remitting. Remitting and relapsing-remitting patients were combined into a nonpersisting group.

Results: Of 71 NDPH-R patients, 31 (43.7%) also met NDPH-ICHD-2 criteria. The NDPH-mf and the NDPH-ICHD-2 groups were similar in most clinical features though the NDPH-mf group was younger, included more women, and had a higher frequency of depression. The groups were similar in the prevalence of allodynia, triptan responsiveness, and prognosis. NDPH-R prognostic subforms were also very similar, although the persisting subform was more likely to be of white race, to have anxiety or depression, and to have a younger onset age.

Conclusions: Current International Classification of Headache Disorders (ICHD)-2 criteria exclude the majority of patients with primary headache unremitting from onset. The proposed criteria for revised new daily-persistent headache definition not excluding migraine features (NDPH-R) classify these patients into a relatively homogeneous group based on demographics, clinical features, and prognosis. Both new daily-persistent headache with too many migraine features for ICHD-2 and new daily-persistent headache meeting ICHD-2 criteria include patients in equal proportions that fall into the persisting, remitting, and relapsing-remitting subgroups. Our criteria for NDPH-R should be considered for inclusion in ICHD-3.

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References

    1. Petterson VH, Esmonde TF. Comparison of the handling of neurological outpatient referrals by general physicians and a neurologist. J Neurol Neurosurg Psychiatry 1993;56:830 - PMC - PubMed
    1. Grande RB, Aaseth K, Lundqvist C, Russell MB. Prevalence of new daily persistent headache in the general population: The Akershus Study of Chronic Headache. Cephalalgia 2009;29:1149–1955 - PubMed
    1. Castillo J, Munoz P, Guitera V, et al. Kaplan Award 1998: Epidemiology of chronic daily headache in the general population. Headache 1999;39:190–196 - PubMed
    1. Bigal ME, Lipton RB, Tepper SJ, et al. Primary chronic daily headache and its subtypes in adolescents and adults. Neurology 2004;63:843–847 - PubMed
    1. Kung E, Tepper SJ, Rapoport AM, Sheftell FD, Bigal ME. New daily persistent headache in the paediatric population. Cephalagia 2009;29:17–22 - PubMed

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