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Chronic daily headache: a time perspective
E L Spierings1, A H Ranke, M Schroevers
1Department of Neurology, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
Headache
|April 12, 2000
Summary
Most chronic daily headaches evolve from intermittent ones, often gradually over a decade. While initial headache severity impacts symptoms, the final daily headache presentation remains consistent, with many patients eventually returning to intermittent headache patterns.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Chronic daily headache (CDH) affects a significant patient population.
- Understanding the progression from intermittent to chronic headache is crucial for effective management.
Purpose of the Study:
- To investigate the development and long-term outcomes of chronic daily headache.
- To analyze the transition patterns from intermittent to daily headache.
Main Methods:
- Retrospective analysis of 258 patients diagnosed with headache.
- Follow-up interviews conducted via telephone with 91 patients.
Main Results:
- 22% of patients presented with immediate daily headaches; 78% initially had intermittent headaches.
- Of those with intermittent headaches, 19% transitioned abruptly and 81% gradually (average 10.7 years).
- Initial headache severity (mild vs. severe) did not alter the final daily headache presentation; 67% of patients who transitioned gradually eventually returned to intermittent headaches.
Conclusions:
- Chronic daily headache often develops gradually from pre-existing intermittent headaches.
- The majority of patients who develop CDH may revert to intermittent patterns over time.
- Migraine characteristics are often preserved during the transition and reversion phases.