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Published on: June 2, 2014
Features and Management of New Daily Persistent Headache in Developmental-Age Patients
Laura Papetti1, Giorgia Sforza1, Samuela Tarantino1
1Department of Neuroscience, Paediatric Headache Center, Bambino Gesù Children Hospital, 00165 Rome, Italy.
Insights
Primary new daily persistent headache (NDPH) in children often resembles migraine and frequently starts in winter. While some treatments offer partial relief, optimal long-term therapy for this disabling condition remains unclear.
Area of Science:
- Pediatric Neurology
- Headache Medicine
- Clinical Research
Background:
- New daily persistent headache (NDPH) is a disabling condition.
- Understanding its clinical features in children is crucial for effective management.
Purpose of the Study:
- To investigate the clinical characteristics of primary new daily persistent headache (NDPH) in a pediatric patient cohort.
- To explore correlations between NDPH and patient demographics, headache features, and treatment responses.
Main Methods:
- Retrospective review of 46 pediatric patients diagnosed with NDPH using ICHD-III criteria.
- Statistical analysis to identify associations with age, sex, pain characteristics, and therapy outcomes.
Main Results:
- Headache features in NDPH patients were more similar to migraine (62%) than tension-type headache (38%).
- NDPH onset occurred more frequently in winter months (75%), and was less common in children under 10.
- Amitriptyline was the most common pharmacological therapy, with 30.6% of patients achieving at least 50% reduction in attacks.
Conclusions:
- NDPH is a significant cause of disability in children, with a notable correlation to seasonal onset.
- While long-term pharmacological therapy is suggested, evidence-based treatment choices are limited due to the chronic nature of NDPH.
Introduction:
Our aim was to investigate the clinical features of primary new daily persistent headache (NDPH) in a cohort of paediatric patients.
Methods:
We reviewed the data of patients with persistent daily headache, attending the Headache Centre of Bambino Gesù Children from the January 2009. The ICHD-III criteria were used for diagnosis. Statistical analysis was conducted to study possible correlations between NDPH and population features (age and sex), NDPH and headache qualitative features, and NDPH and response to pharmacological therapies.
Results:
We included 46 subjects with NDPH. The features of pain more closely resembled those of migraine than to those of tension-type headache (62 vs. 38%). The NDPH patients showed nausea and vomiting less frequently than migraine ones (28.6 vs. 48.2%, p < 0.01). A total of 75% of NDPH patients experienced an onset of the symptoms in the winter months (November to February) (p < 0.01). NDPH was less common in very young children under 10 years of age. Almost 58% of NDPH patients received pharmacological therapy and the most used drug was amitriptyline. A reduction of attacks by at least 50% in a month was detected in 30.6% of patients.
Conclusions:
NDPH can be very disabling and correlates with seasonal factors. Although long term pharmacological therapy is recommended, considering the long duration that this headache can have, there are no data supporting the treatment choice.
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