Clinical Features of New Daily Persistent Headache in a Tertiary Outpatient Population

To analyze the clinical features of new daily persistent headache (NDPH) in the neurological outpatient clinic of a tertiary hospital in China.

A cross-sectional survey was conducted between July and December 2011 in the First Affiliated Hospital of Chongqing Medical University. All consecutive patients who cited headache as their chief complaint were asked to participate in a face-to-face interview by a qualified headache specialist through a detailed headache questionnaire, and the diagnosis of NDPH was according to the modified version criteria of the International Classification of Headache Disorders.

A total of 38 were diagnosed as NDPH among 1219 patients with headache, including 20 women and 18 men. The mean age was 42.1 years. The duration of headache ranged from 3 months to 30 years. Headache location was bilateral in 84.2% of the patients. The intensity of pain was mainly described as mild and moderate. Nausea occurred in 21.1% of the patients, vomiting in 5.3%, photophobia in 15.8%, phonophobia in 10.5%, and vertigo in 18.4%. Seventy-nine percent of the patients were able to pinpoint the exact month when their headache started. Trigger factors were noted in 47.4% of the patients, which consisted of stressful life events, flu-like illnesses, surgeries, and some other reasons. Twenty-six patients were able to be followed up by telephone, and 16 had good outcomes.

NDPH is underrecognized in China. This study outlines the clinical features of patients with NDPH in a tertiary outpatient population. Better education among physicians is needed urgently so as to improve the diagnosis and treatment of NDPH.