Clinical and prognostic subforms of new daily-persistent headache

Matthew S. Robbins, B. M. Grosberg, U. Napchan, S. C. Crystal, Richard B. Lipton

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
Pages (from-to)1358-1364
Number of pages7
JournalNeurology
Volume74
Issue number17
DOIs
StatePublished - Apr 2010

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Headache
Headache Disorders
Migraine Disorders
Demography
Primary Headache Disorders
Depression
Tryptamines
Hyperalgesia
Age of Onset

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Robbins, M. S., Grosberg, B. M., Napchan, U., Crystal, S. C., & Lipton, R. B. (2010). Clinical and prognostic subforms of new daily-persistent headache. Neurology, 74(17), 1358-1364. https://doi.org/10.1212/WNL.0b013e3181dad5de

Clinical and prognostic subforms of new daily-persistent headache. / Robbins, Matthew S.; Grosberg, B. M.; Napchan, U.; Crystal, S. C.; Lipton, Richard B.

In: Neurology, Vol. 74, No. 17, 04.2010, p. 1358-1364.

Research output: Contribution to journalArticle

Robbins, MS, Grosberg, BM, Napchan, U, Crystal, SC & Lipton, RB 2010, 'Clinical and prognostic subforms of new daily-persistent headache', Neurology, vol. 74, no. 17, pp. 1358-1364. https://doi.org/10.1212/WNL.0b013e3181dad5de
Robbins, Matthew S. ; Grosberg, B. M. ; Napchan, U. ; Crystal, S. C. ; Lipton, Richard B. / Clinical and prognostic subforms of new daily-persistent headache. In: Neurology. 2010 ; Vol. 74, No. 17. pp. 1358-1364.
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