New Daily Persistent Headache (NDPH): Symptoms and Treatment

New Daily Persistent Headache

New daily persistent headache occurs when a headache suddenly occurs followed by daily occurrences over an extended period of time. You will usually recall the circumstances and sometimes even the exact date of your first headache, which is a distinguishing feature of this type of headache.

NDPH is defined as any headache that meets the criteria listed below, as defined by the International Classification of Headache Disorders, 3rd edition.

NDPH headache characteristics

  • Once the headache begins, it becomes chronic, occurring every day within 24 hours.
  • When the headache begins, it can be pinpointed.
  • It lasts for more than three months.
  • No other condition is present.
  • This is not a headache that has previously occurred more frequently.

An NDPH headache is one that lasts more than four hours and occurs more than 15 times a month for a period of three months or more. Chronic daily headaches can be like other chronic types, such as:

What is new daily persistent headache?

New daily persistent headache is a primary headache disorder, meaning it is not related to another medical condition. These headaches can be very debilitating. Persons with this disorder usually recall the exact date or time when they first experienced a headache.

The headache will usually persist for 24 hours after it has begun. Subsequent headaches usually last for a longer period of time. People without a history of headaches are often affected by NDPH. It occurs after an illness or surgery in about half of the cases, but often there is no clear cause.

NDPH is two to three times more common in females and nearly half of those with it have a close family member experiencing frequent headaches, though the reason for this is unclear. Although the symptoms of NDPH can be similar to those of a persistent headache related to another illness, the two disorders are different.

Read: Sinus Headache

What are the symptoms of new daily persistent headache?

The symptoms of NDPH are sudden onset, persistent daily headache, and the memory of its onset. Symptoms vary from one person to another because the diagnosis is made based on the symptoms associated with its onset, not by the type or location of the pain.

Symptoms of new daily persistent headache involve headache pain that:

  • Headaches usually throb like migraines or tighten like tension headaches
  • Symptoms such as nausea and vomiting, as well as light sensitivity, are sometimes related to migraines
  • Sometimes it affects only one side of the head, but it can also affect both sides
  • Moderate to severe
  • Symptoms may improve or deteriorate throughout the day

What are the causes of NDPH?

There are two kinds of chronic daily headaches: primary headaches with unknown causes, and secondary headaches with another underlying cause. Chronic daily headaches with NDPH are never secondary. The diagnosis is the underlying condition when a secondary cause is found. This includes:

  • Brain bleeding caused by subdermal hematomas or epidural hematomas
  • Brain clots in the veins
  • Head injury
  • Medication overuse
  • Meningitis
  • Pseudotumor cerebri. elevated spinal fluid levels
  • Decrease in spinal fluid pressure causing a headache
  • Temporal arteritis

Read: Cluster Headaches

Risk factors for NDPH

There are no known risk factors, but triggers could exist. Headache published a study indicating these possible triggers:

Only just over half of those who had NDPH had a trigger in this study.

What is the diagnosis of NDPH?

There is no test that can diagnose NDPH. Rather, it is determined what happened to cause your headaches and how they progressed. First, you need to have a continuous headache and remember what caused it to suddenly begin.

Imaging tests and tests are used for two reasons:

  • It is important to exclude any underlying conditions that might cause headaches before making a diagnosis.
  • Subarachnoid hemorrhage and cerebral venous sinus thrombosis are two of the underlying conditions that can result in life-threatening conditions that require immediate and appropriate treatment.

Other possible causes can be excluded with the following tests:

  • CT scan
  • MRI
  • Spinal fluid analysis using a lumbar puncture

It’s possible that your headaches are caused by medication overuse, so ask your doctor about the medication types and frequency you’re taking. NDPH can ultimately be diagnosed based on a headache pattern that is consistent with the condition along with the absence of an underlying cause.

Read: Thunderclap Headaches

NDPH Treatment

There is no one treatment for new daily persistent headache, which is poorly understood. Doctors often recommend therapies to reduce pain based on the type of headache that the headache most closely resembles, either migraines or tension headaches.

Medications that can reduce the pain include:

  • Pain-receptor-targeting antidepressants, such as nortriptyline and amitriptyline
  • Topiramate, an antiseizure medication
  • Candesartan, a blood pressure medication

For treating NDPH, studies have also examined methylprednisolone, antibiotics with tetracyclines, nerve blocking drugs, and Botox injections, according to a systematic review published in 2019. The trials were small, but the results suggest some promise for these options. The effectiveness of these tools must be confirmed across a larger population.

NDPH sufferers should make sure they do not rely on short-term pain medication, such as over-the-counter (OTC) pain relievers, to manage the condition. This could result in a medication-overuse headache. It is not advisable for doctors to prescribe addictive medications, such as barbiturates and opioids.

People can reduce their daily symptoms by using complementary therapies, including biofeedback and relaxation techniques.

Side effects of the treatments

There are a lot of things that can go wrong with the treatments, especially the drugs. What you can do to prevent or minimize side effects and complications depends on what your healthcare provider tells you.

How do I take care of myself?

NDPH can be helped by talking to your doctor about what you can do. You can’t do much to manage this condition, for the most part. Certain treatments – like medications – may work better if you focus on your general health and well-being. Generally speaking, the best health behaviors are:

  • Keep your diet healthy
  • Exercise regularly
  • Get enough sleep and keep a regular schedule

What is the correlation between COVID-19 and headaches?

Chronic headaches can be one of the first symptoms of COVID-19. The number of people with COVID-19 who experience headaches could range from 14 to 60%. It is possible for a person to develop COVID-19-induced headaches fairly quickly and suffer from them every day until they recover. In most cases, mild illnesses last a few weeks and are self-recovering.

Symptoms of COVID-19 can last weeks or months after the initial infection in some people. COVID long-haul or long-distance COVID is what it is called. Although COVID-19 symptoms are typically mild, headaches may occur in people who have developed long COVID. People who have pre-existing migraines may also suffer from worse or more frequent migraine episodes.

COVID-19 is a possible cause of a new persistent headache, so people who develop such a headache should remain at home and seek advice from their local health authority.

Read: Personality Change

The takeaway

Chronic headaches lasting at least 3 months that are new daily persisting headaches (NDPH). A headache usually begins with a clear memory of when it first began. It may also occur after a surgery or infection.

There are no underlying conditions associated with primary headache disorders. It is important to remember that chronic, persistent headaches can also be caused by conditions other than NDPH. There are several such conditions, including chronic migraine, COVID-19, and long COVID. Individuals suffering from chronic headaches or headaches that last for a long time should seek medical attention.

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