New Daily Persistent Headache

This chapter investigates new daily persistent headache (NDPH), which is a rare primary headache disorder characterized by persistent headache with a particular profile because it starts one day with a clearly remembered onset and continues in a daily pattern. NDPH can have either chronic migraine or chronic tension-type headache features. Only a sudden onset and persistence are required for the diagnosis of NDPH. The most important first step in these cases is to exclude secondary causes; a number of occult mimics must be ruled out. However, treatment of NDPH is generally never fully effective. In clinical practice, most headache specialists treat NDPH based on the prominent headache phenotype, whether migrainous or tension-type. Medication overuse is frequently a problem, for obvious reasons, and must be dealt with in order to have a chance at successful outcome.