New Daily Persistent Headache (NDPH)
New Daily Persistent Headache (NDPH) is a variation on the theme of Chronic Daily Headaches (CDH) and has become a notable problem in headache and pain clinics. NDPH was first described in the literature by Vanast1 in 1986 as a more benign form of CDH that improved without therapy. However, that opinion has not persisted. NDPH is now seen as one of the most refractory of all headache types and, in many cases, in spite of the name, may persist indefinitely. In recent years, it has been classified by the International Headache Society (IHS) as a separate variety under the broader heading of Chronic Daily Headache.
The IHS criteria for New Daily Persistent Headache are quite non-specific and closest to ‘chronic tension headache’ in many ways. Following is the published criteria:
- Headache for >3 months fulfilling criteria B-D (below).
- Headache is daily and unremitting from the onset or
- At least two of the following pain characteristics:
- Bilateral location
- Pressing/tightening (nonpulsating) quality.
- mild or moderate intensity
- not aggravated by routine physical activity such as walking or climbing stairs.
- Both of the following
- Not more than one of photophobia, phonophobia, or mild nausea
- Neither moderate or severe nausea nor vomiting
- Not attributed to another disorder.