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Diagnosis and management of chronic daily headache

Ivan Garza1, Todd J Schwedt

  • 1Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA. garza.ivan@mayo.edu

Seminars in Neurology
|March 31, 2010
PubMed

Insights

Chronic daily headache (CDH) affects 4% of adults, causing significant suffering and economic costs. Accurate diagnosis of specific CDH subtypes, like chronic migraine, is crucial for effective management.

Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Chronic daily headache (CDH) affects approximately 4% of adults.
  • CDH significantly impacts quality of life and incurs substantial societal economic costs.
  • While often chronic migraine or tension-type headache, CDH can also stem from secondary causes.

Purpose of the Study:

  • To review the diagnosis and management of primary CDH entities.
  • To emphasize the importance of differentiating specific CDH subtypes for targeted treatment.
  • To highlight the role of medication overuse headache in the context of primary CDH.

Main Methods:

  • Review of literature on diagnosis and management of CDH subtypes.
  • Emphasis on differentiating primary and secondary causes of daily headaches.
  • Discussion of chronic migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua.

Main Results:

  • Accurate diagnosis of specific CDH subtypes is essential for effective treatment.
  • Ruling out secondary headaches is a critical first step in CDH management.
  • Medication overuse headache frequently co-exists with primary CDH.

Conclusions:

  • Proper investigation is necessary to exclude secondary headaches presenting as CDH.
  • Specific diagnosis of primary CDH subtypes (e.g., chronic migraine) guides appropriate therapeutic strategies.
  • Understanding the interplay between primary CDH and medication overuse headache is vital for comprehensive patient care.

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