Nappi Giuseppe, Perrotta Armando, Rossi Paolo, Sandrini Giorgio
University Centre for Adaptive Disorders and Headache, IRCCS C. Mondino Institute of Neurology Foundation, University of Pavia, Italy.
Expert Rev Neurother. 2008 Mar;8(3):361-84. doi: 10.1586/14737175.8.3.361.
The term chronic daily headache (CDH) identifies a heterogeneous group of headaches characterized by the presence of daily or near-daily headache, including forms associated with medication overuse. This group includes chronic (transformed) migraine, chronic tension-type headache, new daily-persistent headache and hemicrania continua. According to population studies, CDH affects 4-5% of the general population worldwide, making it a significant social problem. CDH evolves from an episodic form of headache or, more rarely, is daily from onset. The classification of CDH continues to be debated, even though the recent revision of the diagnostic criteria for several primary headache forms seems to have resolved some of the nosographical difficulties. To date, no specific therapies have been approved for CDH and there have been few large-scale controlled trials of treatments in this area. This article reviews various aspects of CDH: classification issues, pathophysiological hypotheses and therapeutic (pharmacological and nonpharmacological) approaches.
慢性每日头痛（CDH）这一术语指的是一组异质性头痛，其特征为每日或近乎每日发作头痛，包括与药物过度使用相关的类型。这一组包括慢性（转变型）偏头痛、慢性紧张型头痛、新发性每日持续性头痛和持续性偏侧头痛。根据人群研究，CDH在全球普通人群中的发病率为4%至5%，这使其成为一个重大的社会问题。CDH由发作性头痛形式演变而来，或者更罕见的是从发病起就是每日发作。尽管最近对几种原发性头痛形式的诊断标准进行了修订，似乎解决了一些分类学上的难题，但CDH的分类仍存在争议。迄今为止，尚无针对CDH的特效疗法，该领域的大规模对照治疗试验也很少。本文综述了CDH的各个方面：分类问题、病理生理假说以及治疗（药物和非药物）方法。
