Department of Neurology, Cincinnati Children's Hospital, Cincinnati, OH, USA.
Department of Neurology, Mayo Clinic, 13400 E. Shea Boulevard, Scottsdale, AZ, 85259, USA.
Curr Neurol Neurosci Rep. 2019 Mar 19;19(5):21. doi: 10.1007/s11910-019-0936-9.
New daily persistent headache (NDPH) is a rare primary headache disorder, which often has a refractory clinical course. This narrative review seeks to highlight what is known about the development of NDPH, to outline a diagnostic approach to a patient with new daily headache, and to explore management considerations and potential future therapies for patients diagnosed with NDPH.
Interval work at the level of case series and cohort studies has identified novel triggering factors (e.g., Valsalva), subgroups with unique temporal profiles (e.g., thunderclap onset), psychophysical profiles (e.g., increased pain catastrophizing), and potential treatment options. The approach to the diagnosis and treatment of NDPH remains individualized, driven by clinical features and challenging in most cases. Earlier identification of patients (e.g., prediction of patients with status migrainosus destined to develop NDPH) may allow for more effective treatment.
新的每日持续性头痛(NDPH)是一种罕见的原发性头痛疾病,其临床病程往往具有难治性。本综述旨在强调对 NDPH 发展的了解,概述新发每日头痛患者的诊断方法,并探讨诊断为 NDPH 的患者的治疗注意事项和潜在的未来治疗方法。
基于病例系列和队列研究的间隔工作已经确定了新的触发因素(例如,瓦尔萨尔瓦动作)、具有独特时间特征的亚组(例如,霹雳样发作)、心理物理特征(例如,疼痛灾难化增加)和潜在的治疗选择。NDPH 的诊断和治疗方法仍然是个体化的,由临床特征驱动,在大多数情况下具有挑战性。更早地识别患者(例如,预测有偏头痛状态的患者可能会发展为 NDPH)可能会允许更有效的治疗。