Kikui Shoji, Danno Daisuke, Takeshima Takao
Department of Neurology, Headache Center, Tominaga Hospital, Osaka, JPN.
Cureus. 2025 May 19;17(5):e84442. doi: 10.7759/cureus.84442. eCollection 2025 May.
New daily persistent headache (NDPH) is a rare and difficult-to-treat primary headache disorder characterized by a sudden onset of continuous, unremitting pain. We report the case of a 46-year-old Japanese woman with a history of episodic migraine who developed a persistent daily headache with migraine-like features. Despite multiple conventional preventive treatments, her symptoms remained unchanged. Remarkably, she achieved complete and sustained remission after initiating monthly subcutaneous injections of erenumab at a dose of 70 mg. The treatment was maintained for 24 months, during which no recurrence of the continuous headache occurred. This case highlights the diagnostic overlap between NDPH and chronic migraine presenting with continuous daily headache and suggests the potential benefit of calcitonin gene-related peptide-targeted therapy in patients with migraine-like NDPH phenotypes. Careful phenotypic characterization may improve therapeutic decision-making and support a syndromic approach to managing continuous daily headache disorders.
新发性每日持续性头痛（NDPH）是一种罕见且难以治疗的原发性头痛疾病，其特征为突然发作的持续性、不间断疼痛。我们报告了一例46岁的日本女性病例，该患者有发作性偏头痛病史，后来出现了具有偏头痛样特征的持续性每日头痛。尽管接受了多种传统预防性治疗，但其症状仍未改变。值得注意的是，在开始每月皮下注射70毫克erenumab后，她实现了完全且持续的缓解。治疗持续了24个月，在此期间持续性头痛未复发。该病例突出了NDPH与表现为持续性每日头痛的慢性偏头痛之间的诊断重叠，并提示降钙素基因相关肽靶向治疗对具有偏头痛样NDPH表型的患者可能有益。仔细的表型特征分析可能会改善治疗决策，并支持对持续性每日头痛疾病采用综合征方法进行管理。
