Department of Neurology, Medical College, SSG Hospital, Baroda, Gujarat 390001, India.
J Headache Pain. 2010 Feb;11(1):59-66. doi: 10.1007/s10194-009-0171-x.
New daily persistent headache (NDPH) is a subtype of chronic daily headache (CDH) that starts acutely and continues as a daily headache from the onset.It is considered as one of the most treatment refractory of all headache syndromes. The pathophysiology is largely unknown. Viral infections, extracranial surgery, and stressful life events are considered as triggers for the onset of NDPH. A few patients may have the onset of their symptoms during an infection. Here we report nine patients with NDPH like headache. All of them had a history suggestive of extracranial infections a few weeks prior to the onset of headache. All patients received intravenous methylprednisolone (IV MPS) for 5 days. Intravenous MPS was followed by Oral steroids for 2-3 weeks in six patients.The relief of headache started between the second and fifth days of infusion in all patients. The steady improvement in headache continued and seven patients experienced almost complete improvement within 2 weeks. Two other patients showed complete improvement between 6 and 8 weeks after initiation of IV MPS therapy. We conclude that NDPH-like headache may occur as a post infectious process following a recent infection. We also speculate on the possible mechanisms of headache in our patients.
新发每日持续性头痛（NDPH）是慢性每日头痛（CDH）的一种亚型，它从急性发作开始并持续为每日头痛。它被认为是所有头痛综合征中最难治疗的一种。其病理生理学在很大程度上尚不清楚。病毒感染、颅外手术和紧张的生活事件被认为是 NDPH 发作的诱因。少数患者可能在感染期间出现症状。在此，我们报告了 9 例 NDPH 样头痛患者。所有患者在头痛发作前几周均有颅外感染史。所有患者均接受了 5 天的静脉甲基强的松龙（IV MPS）治疗。6 例患者在静脉 MPS 后接受了 2-3 周的口服类固醇治疗。所有患者的头痛缓解均在输注的第 2 至第 5 天开始。头痛持续改善，7 例患者在 2 周内几乎完全缓解。另外 2 例患者在开始 IV MPS 治疗后 6-8 周完全缓解。我们得出结论，NDPH 样头痛可能是近期感染后发生的感染后过程。我们还推测了我们患者头痛的可能机制。
