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Scherbakov D, Mollalo A, Lenert L. Stressful life events in electronic health records: a scoping review. J Am Med Inform Assoc 2024; 31:1025-1035. [PMID: 38349862 PMCID: PMC10990522 DOI: 10.1093/jamia/ocae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/19/2024] [Accepted: 01/27/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES Stressful life events, such as going through divorce, can have an important impact on human health. However, there are challenges in capturing these events in electronic health records (EHR). We conducted a scoping review aimed to answer 2 major questions: how stressful life events are documented in EHR and how they are utilized in research and clinical care. MATERIALS AND METHODS Three online databases (EBSCOhost platform, PubMed, and Scopus) were searched to identify papers that included information on stressful life events in EHR; paper titles and abstracts were reviewed for relevance by 2 independent reviewers. RESULTS Five hundred fifty-seven unique papers were retrieved, and of these 70 were eligible for data extraction. Most articles (n = 36, 51.4%) were focused on the statistical association between one or several stressful life events and health outcomes, followed by clinical utility (n = 15, 21.4%), extraction of events from free-text notes (n = 12, 17.1%), discussing privacy and other issues of storing life events (n = 5, 7.1%), and new EHR features related to life events (n = 4, 5.7%). The most frequently mentioned stressful life events in the publications were child abuse/neglect, arrest/legal issues, and divorce/relationship breakup. Almost half of the papers (n = 7, 46.7%) that analyzed clinical utility of stressful events were focused on decision support systems for child abuse, while others (n = 7, 46.7%) were discussing interventions related to social determinants of health in general. DISCUSSION AND CONCLUSIONS Few citations are available on the prevalence and use of stressful life events in EHR reflecting challenges in screening and storing of stressful life events.
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Affiliation(s)
- Dmitry Scherbakov
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC 29403, United States
| | - Abolfazl Mollalo
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC 29403, United States
| | - Leslie Lenert
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC 29403, United States
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Robbins M. New Daily Persistent Headache. Continuum (Minneap Minn) 2024; 30:425-437. [PMID: 38568492 DOI: 10.1212/con.0000000000001398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This article describes the clinical features, etiology, differential diagnosis, management, and prognosis of new daily persistent headache. LATEST DEVELOPMENTS New daily persistent headache has attracted renewed attention as it may arise in the setting of a COVID-19 infection. Spontaneous intracranial hypotension, particularly from CSF-venous fistulas, remains an important secondary headache disorder to consider before diagnosing new daily persistent headache. Symptomatic treatment for new daily persistent headache may include acute and preventive therapies used for migraine and tension-type headache, such as triptans, oral preventive agents, onabotulinumtoxinA, and agents that target calcitonin gene-related peptide. ESSENTIAL POINTS New daily persistent headache is a daily headache syndrome that starts acutely and can only be diagnosed after 3 months have elapsed and other secondary and primary headache diagnoses have been excluded. The clinical manifestations largely resemble either chronic migraine or chronic tension-type headache. The underlying cause is unknown, but it is plausible that multiple etiologies exist and that it is not a single disease entity. The prognosis is variable but often poor, and the treatment approach is largely extrapolated from the management of chronic migraine and chronic tension-type headache.
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Carrión-Nessi FS, Ascanio LC, Pineda-Arapé AG, Omaña-Ávila ÓD, Mendoza-Millán DL, Romero SR, Almao-Rivero AB, Camejo-Ávila NA, Gebran-Chedid KJ, Rodriguez-Saavedra CM, Freitas-De Nobrega DC, Castañeda SA, Forero-Peña JL, Delgado-Noguera LA, Meneses-Ramírez LK, Cotuá JC, Rodriguez-Morales AJ, Forero-Peña DA, Paniz-Mondolfi AE. New daily persistent headache after SARS-CoV-2 infection in Latin America: a cross-sectional study. BMC Infect Dis 2023; 23:877. [PMID: 38097988 PMCID: PMC10722794 DOI: 10.1186/s12879-023-08898-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Persistent headache is a frequent symptom after coronavirus disease 2019 (COVID-19) and there is currently limited knowledge about its clinical spectrum and predisposing factors. A subset of patients may be experiencing new daily persistent headache (NDPH) after COVID-19, which is among the most treatment-refractory primary headache syndromes. METHODS We conducted a cross-sectional study in Latin America to characterize individuals with persistent headache after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to identify factors associated with NDPH. Participants over 18 years old who tested positive for SARS-CoV-2 infection and reported persistent headache among their symptoms completed an online survey that included demographics, past medical history, persistent headache clinical characteristics, and COVID-19 vaccination status. Based on participants' responses, NDPH diagnostic criteria were used to group participants into NDPH and non-NDPH groups. Participant data was summarized by descriptive statistics. Student's t and Mann-Whitney U tests were used according to the distribution of quantitative variables. For categorical variables, Pearson's chi-square and Fisher's exact tests were used according to the size of expected frequencies. Binomial logistic regression using the backward stepwise selection method was performed to identify factors associated with NDPH. RESULTS Four hundred and twenty-one participants from 11 Latin American countries met the inclusion criteria. One in four participants met the NDPH diagnostic criteria. The mean age was 40 years, with most participants being female (82%). Over 90% of the participants reported having had mild/moderate COVID-19. Most participants had a history of headache before developing COVID-19 (58%), mainly migraine type (32%). The most predominant clinical characteristics in the NDPH group were occipital location, severe/unbearable intensity, burning character, and radiating pain (p < 0.05). A higher proportion of anxiety symptoms, sleep problems, myalgia, mental fog, paresthesia, nausea, sweating of the face or forehead, and ageusia or hypogeusia as concomitant symptoms were reported in participants with NDPH (p < 0.05). Palpebral edema as a concomitant symptom during the acute phase of COVID-19, occipital location, and burning character of the headache were risk factors associated with NDPH. CONCLUSION This is the first study in Latin America that explored the clinical spectrum of NDPH after SARS-CoV-2 infection and its associated factors. Clinical evaluation of COVID-19 patients presenting with persistent headache should take into consideration NDPH.
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Affiliation(s)
- Fhabián S Carrión-Nessi
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Luis C Ascanio
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Andreína G Pineda-Arapé
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
| | - Óscar D Omaña-Ávila
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Daniela L Mendoza-Millán
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Sinibaldo R Romero
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Medical Scientist Training Program (MD/PhD), University of Minnesota Medical School, Minneapolis, MN, USA
| | - Abranny B Almao-Rivero
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
| | - Natasha A Camejo-Ávila
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
| | | | | | - Diana C Freitas-De Nobrega
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
| | - Sergio A Castañeda
- Centro de Investigaciones en Microbiología y Biotecnología, Facultad de Ciencias Naturales, Universidad del Rosario (CIMBIUR), Universidad del Rosario, Bogotá, Colombia
| | - José L Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Lourdes A Delgado-Noguera
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela
| | - Lucianny K Meneses-Ramírez
- "Dr. Francisco Battistini Casalta" Health Sciences School, University of Oriente - Bolivar Nucleus, Ciudad Bolivar, Venezuela
| | - Juan C Cotuá
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Alfonso J Rodriguez-Morales
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
- Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
| | - David A Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela.
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela.
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela.
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela.
| | - Alberto E Paniz-Mondolfi
- Department of Infectious Diseases and Tropical Medicine, Venezuelan Science Incubator, Barquisimeto, Venezuela.
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
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Scherbakov D, Mollalo A, Lenert L. Stressful life events in electronic health records: a scoping review. RESEARCH SQUARE 2023:rs.3.rs-3458708. [PMID: 37886439 PMCID: PMC10602151 DOI: 10.21203/rs.3.rs-3458708/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Objective Stressful life events, such as going through divorce, can have an important impact on human health. However, there are challenges in capturing these events in electronic health records (EHR). We conducted a scoping review aimed to answer two major questions: how stressful life events are documented in EHR and how they are utilized in research and clinical care. Materials and Methods Three online databases (EBSCOhost platform, PubMed, and Scopus) were searched to identify papers that included information on stressful life events in EHR; paper titles and abstracts were reviewed for relevance by two independent reviewers. Results 557 unique papers were retrieved, and of these 70 were eligible for data extraction. Most articles (n=36, 51.4%) were focused on the statistical association between one or several stressful life events and health outcomes, followed by clinical utility (n=15, 21.4%), extraction of events from free-text notes (n=12, 17.1%), discussing privacy and other issues of storing life events (n=5, 7.1%), and new EHR features related to life events (n=4, 5.7%). The most frequently mentioned stressful life events in the publications were child abuse/neglect, arrest/legal issues, and divorce/relationship breakup. Almost half of the papers (n=7, 46.7%) that analyzed clinical utility of stressful events were focused on decision support systems for child abuse, while others (n=7, 46.7%) were discussing interventions related to social determinants of health in general. Discussion and Conclusions Few citations are available on the prevalence and use of stressful life events in EHR reflecting challenges in screening and storing of stressful life events.
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Affiliation(s)
- Dmitry Scherbakov
- Biomedical Informatics Center, Department of Public Health Sciences, Medical University of South Carolina
| | - Abolfazl Mollalo
- Biomedical Informatics Center, Department of Public Health Sciences, Medical University of South Carolina
| | - Leslie Lenert
- Biomedical Informatics Center, Department of Public Health Sciences, Medical University of South Carolina
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5
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Scherbakov D, Mollalo A, Lenert L. Stressful life events in electronic health records: a scoping review. RESEARCH SQUARE 2023:rs.3.rs-3458708. [PMID: 37886439 PMCID: PMC10602151 DOI: 10.21203/rs.3.rs-3458708/v2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Objective Stressful life events, such as going through divorce, can have an important impact on human health. However, there are challenges in capturing these events in electronic health records (EHR). We conducted a scoping review aimed to answer two major questions: how stressful life events are documented in EHR and how they are utilized in research and clinical care. Materials and Methods Three online databases (EBSCOhost platform, PubMed, and Scopus) were searched to identify papers that included information on stressful life events in EHR; paper titles and abstracts were reviewed for relevance by two independent reviewers. Results 557 unique papers were retrieved, and of these 70 were eligible for data extraction. Most articles (n=36, 51.4%) were focused on the statistical association between one or several stressful life events and health outcomes, followed by clinical utility (n=15, 21.4%), extraction of events from free-text notes (n=12, 17.1%), discussing privacy and other issues of storing life events (n=5, 7.1%), and new EHR features related to life events (n=4, 5.7%). The most frequently mentioned stressful life events in the publications were child abuse/neglect, arrest/legal issues, and divorce/relationship breakup. Almost half of the papers (n=7, 46.7%) that analyzed clinical utility of stressful events were focused on decision support systems for child abuse, while others (n=7, 46.7%) were discussing interventions related to social determinants of health in general. Discussion and Conclusions Few citations are available on the prevalence and use of stressful life events in EHR reflecting challenges in screening and storing of stressful life events.
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Affiliation(s)
- Dmitry Scherbakov
- Biomedical Informatics Center, Department of Public Health Sciences, Medical University of South Carolina
| | - Abolfazl Mollalo
- Biomedical Informatics Center, Department of Public Health Sciences, Medical University of South Carolina
| | - Leslie Lenert
- Biomedical Informatics Center, Department of Public Health Sciences, Medical University of South Carolina
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Zhang X, Wang W, Zhang X, Bai X, Yuan Z, Zhang P, Bai R, Jiao B, Zhang Y, Li Z, Tang H, Zhang Y, Yu X, Wang Y, Sui B. Normal glymphatic system function in patients with new daily persistent headache using diffusion tensor image analysis along the perivascular space. Headache 2023; 63:663-671. [PMID: 37140029 DOI: 10.1111/head.14514] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To investigate the glymphatic function in patients with new daily persistent headache (NDPH) using the diffusion tensor image analysis along the perivascular space (DTI-ALPS) method. BACKGROUND NDPH, a rare and treatment-refractory primary headache disorder, is poorly understood. There is limited evidence to suggest that headaches are associated with glymphatic dysfunction. Thus far, no studies have evaluated glymphatic function in patients with NDPH. METHODS In this cross-sectional study conducted in the Headache Center of Beijing Tiantan Hospital, patients with NDPH and healthy controls were enrolled. All participants underwent brain magnetic resonance imaging examinations. Clinical characteristics and neuropsychological evaluation were examined in patients with NDPH. ALPS indexes for both hemispheres were measured to determine the glymphatic system function in patients with NDPH and healthy controls. RESULTS In total, 27 patients with NDPH (14 males, 13 females; age [mean ± standard deviation (SD)]: 36.6 ± 20.6) and 33 healthy controls (15 males, 18 females; age [mean ± SD]: 36.0 ± 10.8) were included in the analysis. No significant differences between groups were observed in the left ALPS index (1.583 ± 0.182 vs. 1.586 ± 0.175, mean difference = 0.003, 95% confidence interval [CI] of difference = -0.089 to 0.096, p = 0.942), or right ALPS index (1.578 ± 0.230 vs. 1.559 ± 0.206, mean difference = -0.027, 95% CI of difference = -0.132 to 0.094, p = 0.738). Additionally, ALPS indexes were not correlated with clinical characteristics or neuropsychiatric scores. CONCLUSION No glymphatic dysfunction was detected in patients with NDPH by means of the ALPS method. Additional studies with larger samples are needed to confirm these preliminary findings and improve the understanding of glymphatic function in NDPH.
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Affiliation(s)
- Xue Zhang
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xueyan Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoyan Bai
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ziyu Yuan
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peng Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ruiliang Bai
- Department of Physical Medicine and Rehabilitation of the Affiliated Sir Run Shumen Shaw Hospital and Interdisciplinary Institute of Neuroscience and Technology, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
- MOE Frontier Science Center for Brain Science and Brain-Machine Integration, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China
| | - Bingjie Jiao
- Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Yingkui Zhang
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Zhiye Li
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hefei Tang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yaqing Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xueying Yu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yonggang Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Binbin Sui
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, Beijing, China
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Qiu D, Wang W, Mei Y, Tang H, Yuan Z, Zhang P, Zhang Y, Yu X, Yang C, Wang Q, Wang Y. Brain structure and cortical activity changes of new daily persistent headache: multimodal evidence from MEG/sMRI. J Headache Pain 2023; 24:45. [PMID: 37098498 PMCID: PMC10129440 DOI: 10.1186/s10194-023-01581-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/18/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND New daily persistent headache (NDPH) is a rare but debilitating primary headache disorder that poses a significant burden on individuals and society. Despite its clinical importance, the underlying pathophysiological mechanisms of NDPH remain unclear. In this study, we aimed to investigate the brain structural changes and neural activity patterns in patients with NDPH using multimodal brain imaging analysis of structural magnetic resonance imaging (sMRI) combined with magnetoencephalography (MEG). METHODS Twenty-eight patients with NDPH and 37 healthy controls (HCs) were recruited for this study, and their structural and resting-state data were collected by 3.0 Tesla MRI and MEG. We analyzed the brain morphology using voxel-based morphometry and source-based morphometry. In each brain region, MEG sensor signals from 1 to 200 Hz were analyzed using an adapted version of Welch's method. MEG source localization was conducted using the dynamic statistical parametric mapping, and the difference of source distribution between patients with NDPH and HCs was examined. RESULTS Our results revealed significant differences in the regional grey matter volume, cortical thickness, and cortical surface area between the two groups. Specifically, compared with HCs, patients with NDPH showed a significant decrease in cortical thickness of the left rostral cortex in the middle frontal gyrus, decreased cortical surface area of the left fusiform gyrus, decreased grey matter volume of the left superior frontal gyrus and the left middle frontal gyrus, and increased grey matter volume of the left calcarine. Furthermore, the power of the whole brain, bilateral frontal lobes, and right temporal lobe in the NDPH group were higher than that in HCs in the ripple frequency band (80-200 Hz). Functional and structural analysis suggested that there were structural changes and abnormal high frequency cortical activity in both frontal and temporal lobes in patients with NDPH. CONCLUSION Our findings indicated that patients with NDPH have abnormalities in brain morphology, such as cortical area, cortical thickness, and grey matter volume, accompanied by abnormal cortical neural activity. Brain structural changes in the frontotemporal cortex and abnormalities in cortical ripple activity may be involved in the pathogenesis of NDPH.
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Affiliation(s)
- Dong Qiu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China
| | - Wei Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China
| | - Yanliang Mei
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China
| | - Hefei Tang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China
| | - Ziyu Yuan
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China
| | - Peng Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China
| | - Yaqing Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China
| | - Xueying Yu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China
| | - Chunqing Yang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China
| | - Qun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China
| | - Yonggang Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China.
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Fairweather D, Bruno KA, Darakjian AA, Bruce BK, Gehin JM, Kotha A, Jain A, Peng Z, Hodge DO, Rozen TD, Munipalli B, Rivera FA, Malavet PA, Knight DRT. High overlap in patients diagnosed with hypermobile Ehlers-Danlos syndrome or hypermobile spectrum disorders with fibromyalgia and 40 self-reported symptoms and comorbidities. Front Med (Lausanne) 2023; 10:1096180. [PMID: 37181352 PMCID: PMC10166812 DOI: 10.3389/fmed.2023.1096180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
Background Joint pain is a common symptom in patients with hypermobile Ehlers-Danlos Syndrome (hEDS), hypermobility spectrum disorders (HSD) and fibromyalgia. The goal of this study was to determine whether symptoms and comorbidities overlap in patients diagnosed with hEDS/HSD and/or fibromyalgia. Methods We retrospectively examined self-reported data from an EDS Clinic intake questionnaire in patients diagnosed with hEDS/HSD, fibromyalgia, or both vs. controls with an emphasis on joint issues. Results From 733 patients seen at the EDS Clinic, 56.5% (n = 414) were diagnosed with hEDS/HSD and fibromyalgia (Fibro), 23.8% (n = 167) hEDS/HSD, 13.3% (n = 98) fibromyalgia, or 7.4% (n = 54) none of these diagnoses. More patients were diagnosed with HSD (76.6%) than hEDS (23.4%). Patients were primarily White (95%) and female (90%) with a median age in their 30s (controls 36.7 [18.0, 70.0], fibromyalgia 39.7 [18.0, 75.0], hEDS/HSD 35.0 [18.0, 71.0], hEDS/HSD&Fibro 31.0 [18.0, 63.0]). There was high overlap in all 40 symptoms/comorbidities that we examined in patients diagnosed with fibromyalgia only or hEDS/HSD&Fibro, regardless of whether they had hEDS or HSD. Patients that only had hEDS/HSD without fibromyalgia had far fewer symptoms/comorbidities than patients with hEDS/HSD&Fibro. The top self-reported issues in patients that only had fibromyalgia were joint pain, hand pain when writing or typing, brain fog, joint pain keeping from daily activities, allergy/atopy and headache. Five issues that significantly and uniquely characterized patients diagnosed with hEDS/HSD&Fibro were subluxations (dislocations in hEDS patients), joint issues like sprains, the need to stop sports due to injuries, poor wound healing, and migraine. Conclusion The majority of patients seen at the EDS Clinic had a diagnosis of hEDS/HSD plus fibromyalgia that was associated with more severe disease. Our findings indicate that fibromyalgia should be routinely assessed in patients with hEDS/HSD and vis-a-versa to improve patient care.
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Affiliation(s)
- DeLisa Fairweather
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Katelyn A. Bruno
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
- Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States
| | - Ashley A. Darakjian
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Barbara K. Bruce
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, United States
| | - Jessica M. Gehin
- Department of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Archana Kotha
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Angita Jain
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Zhongwei Peng
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, United States
| | - David O. Hodge
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, United States
| | - Todd D. Rozen
- Department of Neurology, Mayo Clinic, Jacksonville, FL, United States
| | - Bala Munipalli
- Department of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Fernando A. Rivera
- Department of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Pedro A. Malavet
- Department of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Dacre R. T. Knight
- Department of General Internal Medicine, Mayo Clinic, Jacksonville, FL, United States
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New-onset headache following COVID-19: An Italian multicentre case series. J Neurol Sci 2023; 446:120591. [PMID: 36807975 PMCID: PMC9931424 DOI: 10.1016/j.jns.2023.120591] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To describe the characteristics of patients with new-onset headache following SARS-CoV-2 infection. BACKGROUND SARS-CoV-2 infection leads to several neurological manifestations, and headache is a frequent and disabling symptom, both exacerbating pre-existing headache syndromes and causing new-onset ones. METHODS Patients with new-onset headache after SARS-CoV-2 infection with consent to participate were included, while those ones with previous headaches were excluded. The temporal latency of headache after infection, pain characteristics, and concomitant symptoms were analysed. Moreover, the efficacy of acute and preventive medications was explored. RESULTS Eleven females (median age 37.0 [10.0-60.0] years old) were included. In most cases, headache onset occurred with the infection, the location of pain varied, and the quality was either pulsating or tightening. Headache was persistent and daily in 8 patients (72.7%), while it occurred in episodes in the remaining subjects. Baseline diagnoses were new daily persistent headache (36.4%), probable new daily persistent headache (36.4%), probable migraine (9.1%), and migraine-like headache secondary to COVID-19 (18.2%). Ten patients received one or more preventive treatments and six of them showed an improvement. CONCLUSION New-onset headache following COVID-19 is a heterogenous condition with uncertain pathogenesis. This type of headache can become persistent and severe, with a wide spectrum of manifestations (new daily persistent headache being the most represented one) and variable response to treatment.
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10
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Abstract
Background Accumulating evidence suggests various specific triggers may lead to new daily persistent headache (NDPH)-like presentations, suggesting that new daily persistent headache is a heterogenous syndrome, and challenging the concept that new daily persistent headache is a primary headache disorder.Method We searched the PubMed database up to August 2022 for keywords including persistent daily headache with both primary and secondary etiologies. We summarized the literature and provided a narrative review of the clinical presentation, diagnostic work-ups, possible pathophysiology, treatment response, and clinical outcomes.Results and conclusion New daily persistent headache is a controversial but clinically important topic. New daily persistent headache is likely not a single entity but a syndrome with different etiologies. The issue with past studies of new daily persistent headache is that patients with different etiologies/subtypes were pooled together. Different studies may investigate distinct subsets of patients, which renders the inter-study comparison, both positive and negative results, difficult. The identification (and removal) of a specific trigger might provide the opportunity for clinical improvement in certain patients, even when the disease has lasted for months or years. Nonetheless, if there is a specific trigger, it remains unknown or unidentified for a great proportion of the patients. We need to continue to study this unique headache population to better understand underlying pathogenesis and, most importantly, to establish effective treatment strategies that hopefully resolve the continuous cycle of pain.
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Affiliation(s)
- Kuan-Po Peng
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Todd D Rozen
- Department of Neurology, Mayo Clinic, Florida, USA
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11
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Cocores AN, Goadsby PJ, Monteith TS. Post-vaccination headache reporting: Trends according to the Vaccine Adverse Events Reporting System. Headache 2023; 63:275-282. [PMID: 36651626 DOI: 10.1111/head.14458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/29/2022] [Accepted: 10/03/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To assess the characteristics and associated disability of headache as an adverse event following vaccination. BACKGROUND According to clinical trials and post-licensure surveillance, headache is a common symptom of vaccines, yet systematic investigations of post-licensure reports of this adverse event are lacking. METHODS This was a retrospective database analysis study. We searched the Vaccine Adverse Events Reporting System (VAERS) database completed from July 1990 to June 2020 (a 30-year period prior to the start of COVID-19 pandemic) to identify reports of headache. We evaluated epidemiological features, including event characteristics, patient demographics, and vaccine type. RESULTS In those aged 3 years or older, headache was the fifth most reported adverse symptom, present in 8.1% (43,218/536,120) of all reports. Of headache reports, 96.3% (41,635/43,218) included the code "headache" not further specified. Migraine was coded in 1973 cases, although almost one-third (12,467/41,808; 29.8%) of headache reports without a migraine code mention nausea or vomiting. The onset of symptoms was within 1 day of vaccination in over two-thirds of cases. The majority of reports were classified as not serious; about one-third involved emergency room or office visits. Of the 43,218 total headache reports, only a minority involved hospitalizations (2624; 6.1%) or permanent disability (1091; 2.5%), females accounted for 68.9% (29,771) and males for 29.5% (12,725), patients aged 6 to 59 years represented 67.3% (29,112), and over one-third of cases were reported after herpes zoster (8665; 20.1%) and influenza (6748; 15.6%) vaccinations. CONCLUSION In a national surveillance system, headache was a commonly reported post-vaccination adverse event; a small subset of reports was considered serious. The development of standardized vaccine-related case definitions could be useful for better evaluating headache as an adverse event during vaccine development, and may reduce vaccine hesitancy especially in headache-prone individuals.
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Affiliation(s)
- Alexandra N Cocores
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Peter J Goadsby
- NIHR King's Clinical Research Facility & Headache Group-Wolfson CARD, King's College London, London, UK.,Department of Neurology, University of California, Los Angeles, Los Angeles, California, USA
| | - Teshamae S Monteith
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
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12
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Akıncı T. Post-discharge persistent headache and smell or taste dysfunction after hospitalisation for COVID-19: a single-centre study. Ir J Med Sci 2023; 192:369-375. [PMID: 35304709 PMCID: PMC8933127 DOI: 10.1007/s11845-022-02980-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 03/13/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To evaluate the frequency, characteristics, and persistence of headache in coronavirus disease-19 (COVID-19) patients who are hospitalised and to determine if there is a link between headache and smell and/or taste dysfunction. MATERIALS AND METHODS In April and May 2020, patients who were hospitalised due to COVID-19 and had headache complaints were evaluated by a neurologist. In addition to clinical COVID-19 features, the characteristics and course of the patients' headaches were evaluated. The patients were contacted by phone 3 months after they were discharged from the hospital to determine the persistence of their symptoms. RESULTS Eighty-five patients were included in the study, 54.1% were female; the mean age was 47.5 ± 13.9 years (between the ages of 21 and 84). Fifty-four patients (65.3%) presented with smell and/or taste dysfunction, and 14 patients (n = 14, 25.9%) still reported that dysfunction 3 months later. Moreover, 17 (20%) still had headaches 3 months after being discharged from the hospital. Persistent smell/taste disorders were significantly (p < 0.001) more frequent in patients with persistent headaches (59%) compared to those without (6%) (p < 0.001). CONCLUSION In this prospective study in COVID-19 patients presenting with headache upon admission, a correlation between persistent headache 3 months after discharge and persistent smell/taste dysfunction was found that could point to common underlying pathophysiology.
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Affiliation(s)
- Tuba Akıncı
- Department of Neurology, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, Selimiye, Tıbbiye Cd No:23, 34668 Üsküdar, Istanbul, Turkey.
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13
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Begasse de Dhaem O, Rizzoli P. Refractory Headaches. Semin Neurol 2022; 42:512-522. [DOI: 10.1055/s-0042-1757925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractMedication overuse headache (MOH), new daily persistent headache (NDPH), and persistent refractory headache attributed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection represent a significant burden in terms of disability and quality of life, and a challenge in terms of definition, pathophysiology, and treatment. Regarding MOH, prevention without withdrawal is not inferior to prevention with withdrawal. Preventive medications like topiramate, onabotulinumtoxinA, and calcitonin gene-related peptide (CGRP) monoclonal antibodies improve chronic migraine with MOH regardless of withdrawal. The differential diagnosis of NDPH is broad and should be carefully examined. There are no guidelines for the treatment of NDPH, but options include a short course of steroids, nerve blocks, topiramate, nortriptyline, gabapentin, CGRP monoclonal antibodies, and onabotulinumtoxinA. The persistence of headache 3 months after SARS-CoV2 infection is a predictor of poor prognosis.
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Affiliation(s)
- Olivia Begasse de Dhaem
- Headache Specialist at Hartford HealthCare, Hartford, Connecticut
- Department of Neurology at the University of Connecticut, Milford, Connecticut
| | - Paul Rizzoli
- Department of Neurology, Brigham and Women's Faulkner Hospital J Graham Headache Center, Boston, Massachusetts
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Nagaraj K, Wei DY, Puledda F, Weng H, Waheed S, Vandenbussche N, Ong JJY, Goadsby PJ. Comparison and predictors of chronic migraine vs. new daily persistent headache presenting with a chronic migraine phenotype. Headache 2022; 62:828-838. [PMID: 35861031 PMCID: PMC9545870 DOI: 10.1111/head.14362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/13/2022] [Accepted: 05/27/2022] [Indexed: 11/29/2022]
Abstract
Objective To compare the clinical phenotype of patients with chronic migraine (CM) to patients with new daily persistent headache of the chronic migraine subtype (NDPH‐CM). Methods A study was conducted of CM (n = 257) and NDPH‐CM (n = 76) from a tertiary headache center in the UK, and in the US of patients with daily CM (n = 60) and NDPH‐CM (n = 22). Results From the UK cohort, the age of first headache onset was lower in CM (mean ± SD: 16 ± 12 years) than in NDPH‐CM (mean ± SD: 23 ± 14 years; p < 0.001). There was a greater number of associated migrainous symptoms in CM compared to NDPH‐CM (median and interquartile range: 6, 5–8 vs. 5, 4–7; p < 0.001). A family history of headache was more common in CM compared to NDPH‐CM (82%, 202/248, vs. 53%, 31/59; p < 0.001). In the US cohort there were no differences. Osmophobia (B = −1.08; p = 0.002) and older age at presentation to the clinic (B = −0.06; p = 0.001) were negative predictors of NDPH‐CM. Conclusion NDPH‐CM is relatively less migrainous than CM in the UK cohort. Family history of headache is less common in NDPH‐CM, with negative predictors for NDPH‐CM including osmophobia and older age of presentation to the clinic. More work is required to understand the chronic migraine phenotype of new daily persistent headache.
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Affiliation(s)
- Karthik Nagaraj
- Headache Group, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- Department of Neurology Bangalore Medical College and Research Institute Bangalore India
| | - Diana Y. Wei
- Headache Group, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- NIHR‐Wellcome Trust King's Clinical Research Facility King's College Hospital London UK
| | - Francesca Puledda
- Headache Group, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- NIHR‐Wellcome Trust King's Clinical Research Facility King's College Hospital London UK
| | - Hsing‐Yu Weng
- Department of Neurology Taipei Municipal Wanfang Hospital Taipei Taiwan
- Department of Neurology, School of Medicine, College of Medicine Taipei Medical University Taipei Taiwan
| | - Sadaf Waheed
- Headache Group, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Nicolas Vandenbussche
- Headache Group, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- Department of Neurology Ghent University Hospital Ghent Belgium
| | - Jonathan J. Y. Ong
- Headache Group, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- Division of Neurology, Department of Medicine National University Hospital, National University Health System Singapore Singapore
- Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
| | - Peter J. Goadsby
- Headache Group, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- NIHR‐Wellcome Trust King's Clinical Research Facility King's College Hospital London UK
- Department of Neurology University of California Los Angeles California USA
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15
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Abstract
Purpose of Review The diagnostic criteria of new daily persistent headache (NDPH) have been revised since 2013. The current review focused on the progress of NDPH research over the last few years. Recent Findings Various new triggers and different NDPH mimics have been reported. The association with both cephalic and extracephalic pathologies suggests that NDPH is rather a syndrome with more than one disease mechanism. Recent clinical studies confirmed that migrainous headache remained the most prominent phenotype of NDPH, echoing the change of the diagnostic criteria in 2013. Diagnostic workup, including imaging studies, was unremarkable, except serving to exclude secondary etiologies. Studies on treatment options have yet shown promising targets, and randomized clinical trials are still lacking. Summary Multiple mechanisms, both cranial and systemic, may be involved synergically in the generation of NDPH-like headaches. The search for effective treatment options should base on better understanding of disease mechanisms.
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Affiliation(s)
- Kuan-Po Peng
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Shuu-Jiun Wang
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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The Enigma of New Daily Persistent Headache: What Solutions for Pediatric Age? Curr Pain Headache Rep 2022; 26:165-172. [DOI: 10.1007/s11916-022-01011-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2021] [Indexed: 11/03/2022]
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17
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Cohen SP, Wang EJ, Doshi TL, Vase L, Cawcutt KA, Tontisirin N. Chronic pain and infection: mechanisms, causes, conditions, treatments, and controversies. BMJ MEDICINE 2022; 1:e000108. [PMID: 36936554 PMCID: PMC10012866 DOI: 10.1136/bmjmed-2021-000108] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/10/2022] [Indexed: 12/20/2022]
Abstract
Throughout human history, infection has been the leading cause of morbidity and mortality, with pain being one of the cardinal warning signs. However, in a substantial percentage of cases, pain can persist after resolution of acute illness, manifesting as neuropathic, nociplastic (eg, fibromyalgia, irritable bowel syndrome), or nociceptive pain. Mechanisms by which acute infectious pain becomes chronic are variable and can include immunological phenomena (eg, bystander activation, molecular mimicry), direct microbe invasion, central sensitization from physical or psychological triggers, and complications from treatment. Microbes resulting in a high incidence of chronic pain include bacteria such as the Borrelia species and Mycobacterium leprae, as well as viruses such as HIV, SARS-CoV-2 and herpeses. Emerging evidence also supports an infectious cause in a subset of patients with discogenic low back pain and inflammatory bowel disease. Although antimicrobial treatment might have a role in treating chronic pain states that involve active infectious inflammatory processes, their use in chronic pain conditions resulting from autoimmune mechanisms, central sensitization and irrevocable tissue (eg, arthropathy, vasculitis) or nerve injury, are likely to cause more harm than benefit. This review focuses on the relation between infection and chronic pain, with an emphasis on common viral and bacterial causes.
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Affiliation(s)
- Steven P Cohen
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Departments of Physical Medicine and Rehabilitation, Neurology, and Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Departments of Physical Medicine and Rehabilitation and Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Eric J Wang
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Tina L Doshi
- Departments of Anesthesiology & Critical Care Medicine and Neurosurgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Lene Vase
- Department of Psychology, Aarhus University Hospital, Aarhus, Denmark
| | - Kelly A Cawcutt
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Nuj Tontisirin
- Department of Anaesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, Mahidol University, Bangkok, Thailand
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18
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Dhand UK. New Daily Persistent Headache-like Presentation Triggered by a Sudden Head Drop in a Patient With Myasthenia Gravis. Neurol Clin Pract 2021; 11:e773-e774. [PMID: 34840906 DOI: 10.1212/cpj.0000000000000953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/07/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Upinder K Dhand
- Tennova Neurology and University of Tennessee Graduate School of Medicine, Knoxville TN
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19
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Evans RW, Turner DP. Clinical features of new daily persistent headache: A retrospective chart review of 328 cases. Headache 2021; 61:1529-1538. [PMID: 34710236 DOI: 10.1111/head.14207] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To describe the clinical features of new daily persistent headache (NDPH) at an outpatient neurology clinic with a subspecialty interest in headache in Houston, Texas. METHODS A retrospective chart review was performed by a neurologist subspecialty certified in headache medicine of all patients seen from September 1, 2011 through February 28, 2020 (8.5 years) with a provisional diagnosis of NDPH and abstracted charts meeting criteria for primary NDPH. RESULTS A total of 328 patients met the International Classification of Headache Disorders, 3rd edition criteria including 215 (65.5%) female patients. The mean age of onset was 40.3 years (range 12-87 years) with a mean age at first consultation in the study clinic of 42.6 years (range 12-87 years). The median [25th, 75th] duration of NDPH at initial consultation was 0.7 [0.3, 2.0] years, and at last visit, it was 1.9 [0.7, 4.8] years. The headaches were side-locked unilateral in 28/328 (8.5%). 12/328 cases (3.6%) with a thunderclap onset are reported. There was no obvious seasonal or other cyclical variation. The pain was usually moderate to severe and more often severe for the migraine phenotype (MP; 260/328 [79.3%] of cases) than for the tension-type phenotype (TTP). Precipitating factors were the following: stressful life events, 67/328 (20.4%); upper respiratory infection or flu-like illness, 33/328 (10.1%); and extracranial surgery, 5/328 (1.5%). Exacerbating or aggravating factors similar to migraine triggers were more often reported with the MP than with the TTP in this sample. For the MP, vertigo or dizziness was reported by 19/260 (7.3%) and a visual aura by 21/260 (8.1%) with descriptions provided. The prognostic types were the following for all patients: persisting (refractory), 305/328 (93.0%); relapsing-remitting, 9/328 (2.7%); and remitting (self-limited), 14/328 (4.3%). CONCLUSION NDPH is typically of moderate to severe intensity often with migraine features without obvious seasonal or other cyclical variation. Most cases are refractory. 3.6% have a thunderclap onset often with a good response to treatment.
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Affiliation(s)
- Randolph W Evans
- Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
| | - Dana P Turner
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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20
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Naegel S, Zeller J, Hougard A, Weise CM, Zuelow S, Kleinschnitz C, Obermann M, Solbach K, Holle D. No structural brain alterations in new daily persistent headache - a cross sectional VBM/SBM study. Cephalalgia 2021; 42:335-344. [PMID: 34601946 DOI: 10.1177/03331024211045653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To identify grey matter alterations in patients suffering new daily persistent headache to enrich the pathophysiological concept of this rare headache disorder characterised by a distinct, clearly remembered onset and its instant chronification. METHOD Magnetic resonance-based voxel-based and surface-based morphometry was used to investigate 23 patients suffering from new daily persistent headache and 23 age- and gender-matched healthy controls with 1.5 Tesla MRI.Independent statistical analysis was performed at three sites using statistical parametric mapping, as well as FSL(FMRIB Software Library)-based approaches. RESULTS No grey matter changes were detected using this sophisticated and cross-checked method. CONCLUSION The absence of structural brain changes in patients with new daily persistent headache contribute to the recent discussion regarding structural alterations in primary headache disorders in general and does not provide evidence for grey matter changes being associated with the pathophysiology of new daily persistent headache. Future research will have to determine the underlying pathophysiological mechanisms of this disorder.
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Affiliation(s)
- Steffen Naegel
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.,Department of Neurology, Westgerman Headache Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Julia Zeller
- Department of Neurology, Westgerman Headache Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.,Paediatric Haematology and Oncology, Paediatrics III, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Anders Hougard
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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- Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty of the University Duisburg-Essen, Essen, Germany
| | - Stefan Zuelow
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.,Department of Diagnostic and Interventional Radiology and Neuroradiology, Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - Christoph Kleinschnitz
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Mark Obermann
- Department of Neurology, Westgerman Headache Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.,Department of Neurology, Klinikum Weser-Egge, Höxter, Germany
| | - Kasja Solbach
- Department of Neurology, Westgerman Headache Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Dagny Holle
- Department of Neurology, Westgerman Headache Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
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21
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Lobo R, Wang M, Lobo S, Bahra A. Time to retire 'New daily persistent headache': Mode of onset of chronic migraine and tension-type headache. Cephalalgia 2021; 42:385-395. [PMID: 34579562 DOI: 10.1177/03331024211044440] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
New daily persistent headache is described as an enigmatic condition with daily headache from onset. It has posed challenges diagnostically and therapeutically.Methods: We conducted a study of patients referred to headache services based in Central and North-East London, United Kingdom, meeting the International Classificaiton of Headache Disorders - 3 criteria for New daily persistent headache. Information on demographics, phenotype and treatment responses were collected. The syndrome of the daily headache was also classified according any other ICHD-3-defined syndrome.Results: Of 162 patients, females comprised 68.5% with median age of onset 35 years. The daily headache experienced was chronic migraine in 89.7% and tension-type headache in 8.8%. Thunderclap-onset New daily persistent headache occurred in 14.8%. More than one headache syndrome was experienced in 15.4%, including cough, hypnic, sexual and stabbing headache. All aura types were experienced, most commonly brainstem aura in 39%. Prior headache was reported 53.7%. A persisting sub-form was present in 51.2%, relapsing remitting in 12.3% and 14.0% reported improvement; 19.8% were lost to follow-up. Only 11.1% reported an antecedent trigger. The most common premorbid disorders were psychiatric in 35.7%. A fifth improved on preventative medication, most commonly amitriptyline, propranolol and topiramate.Conclusion: Our cohort of New daily persistent headache is consistent with a mode of onset of migraine and tension-type headache which occurs in predisposed individuals.
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Affiliation(s)
- Rhannon Lobo
- National Hospital for Neurology and Neurosurgery, 98546National Hospital for Neurology and Neurosurgery, London, UK
| | - Mu Wang
- Department of Neurology, Shanxi Provincial People's Hospital, Taiyuan, 030012, Shanxi Province, China.,Section for Nutrition Research, Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, 4615Imperial College London, Imperial College London, London, UK
| | - Sean Lobo
- Faculty of Life Science and Medicine, King's College London, London, UK
| | - Anish Bahra
- National Hospital for Neurology and Neurosurgery, 98546National Hospital for Neurology and Neurosurgery, London, UK.,Department of Neurology, 9744Barts Health NHS Trust, Whipps Cross Hospital, London, UK
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22
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New Daily Persistent Headache Responsive to Peripheral Nerve Blocks. Can J Neurol Sci 2021; 49:828-830. [PMID: 34526165 DOI: 10.1017/cjn.2021.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Palacios-Ceña D, Talavera B, Gómez-Mayordomo V, Garcia-Azorin D, Gallego-Gallego M, Cuadrado ML, Guerrero-Peral ÁL. Understanding the diagnoses and medical care experience of patients with new daily persistent headache: a qualitative study in Spain. BMJ Open 2021; 11:e048552. [PMID: 34404708 PMCID: PMC8372810 DOI: 10.1136/bmjopen-2020-048552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To explore the experiences of patients suffering from new daily persistent headache (NDPH) regarding the diagnostic process, treatment and medical care. DESIGN A qualitative phenomenological study was conducted. SETTING A specialised headache unit at two university hospitals in Spain between February 2017 and December 2018. PARTICIPANTS Patients diagnosed with NDPH according to the International Classification of Headache disorders (third beta edition). METHODS Purposeful sampling was performed. Data were collected using unstructured and semistructured interviews, researchers' field notes and patients' drawings. An inductive thematic analysis was used to identify significant emerging themes from interviews, field notes and descriptions of patients' drawings. Also, Guillemin's proposal was used to analyse the contents of drawings. RESULTS Nineteen patients with a mean age of 45.3 were recruited. Four main themes emerged: (1) Seeking a diagnosis, patients visit many doctors without receiving a clear answer and their diagnosis is delayed; (2) Self-medication-minimising pill intake, medication is ineffective, and therefore, some patients discontinue treatment, or are flexible with how they take medication; (3) Trying other non-pharmacological options, many patients turn to other therapies and complementary and/or alternative therapies as a second option, however these are ineffective and (4) Medical care, with two subthemes, referrals and lacking continuity of care, and building the doctor-patient relationship. Patients describe how the referral breaks the continuity of care, and how they identify the traits of a doctor who is approachable and which behaviours the doctor should avoid when caring for patients. CONCLUSIONS An in-depth knowledge of the beliefs and expectations of patients with NDPH will allow the professional to establish a relationship of trust, which will improve the patients' knowledge of which therapies are the most appropriate, and to establish expectations based on the relationship with the doctor, and not only on patients' beliefs.
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Affiliation(s)
- Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón/Madrid, Spain
- Research Group of Humanities and Qualitative Research in Health Science, Universidad Rey Juan Carlos, Alcorcón/ Madrid, Spain
| | - Blanca Talavera
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Víctor Gómez-Mayordomo
- Department of Neurology, Hospital Clínico San Carlos. Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| | - David Garcia-Azorin
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - María Luz Cuadrado
- Department of Neurology, Hospital Clínico San Carlos, Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
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Dono F, Consoli S, Evangelista G, D'Apolito M, Russo M, Carrarini C, Calisi D, De Rosa M, Di Pietro M, De Angelis MV, Travaglini D, Sensi SL, Onofrj M, Bonanni L. New daily persistent headache after SARS-CoV-2 infection: a report of two cases. Neurol Sci 2021; 42:3965-3968. [PMID: 34264414 PMCID: PMC8280630 DOI: 10.1007/s10072-021-05444-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/26/2021] [Indexed: 01/12/2023]
Abstract
Background The 2019 Coronavirus (SARS-CoV-2) is a novel respiratory virus which causes Coronavirus Disease19 (COVID-19). Although the predominant clinical picture of COVID-19 is represented by respiratory symptoms, neurological manifestations are being increasingly recognized. Headache, in particular migraine-like and tension types, has been largely reported in patients suffering from COVID-19 both in the acute and the healing phase of the infection. New daily persistent headache (NDPH) is a primary headache characterized by persistent and daily painful symptoms, with pain becoming continuous and non-remitting within 24 h, and lasting more than 3 months. Even though an increasing number of reports describe patients who develop a persistent headache, diagnosis of NPDH has been rarely explored in the context of COVID-19. Methods Two patients with persistent headache and Sars-CoV-2 infection were identified. Both underwent a full clinical and neuroradiological evaluation. Blood sample with inflammatory biomarkers search was also performed. Results According to International Classifications of Headache Disorders diagnosis of probable new daily persistent headache was made. The treatment with high doses of steroids was associated with relief of symptoms. Conclusions Our report described two cases of probable NDPH due to SARS-CoV-2 infection. Clinical evaluation of COVID-19 patients presenting with persistent headache should take into consideration NDPH. Given the supposed major role for neuroinflammation in the genesis of Sars-CoV-2-driven NDPH, immunomodulatory therapy should be promptly started. In line with this hypothesis, we obtained a good therapeutic response to short-term high dose of corticosteroids.
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Affiliation(s)
- Fedele Dono
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.
| | - Stefano Consoli
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Giacomo Evangelista
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Maria D'Apolito
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Claudia Carrarini
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Dario Calisi
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Matteo De Rosa
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Martina Di Pietro
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | | | - Daniela Travaglini
- Department of Neurology, Headache Center, SS Annunziata Hospital, Chieti, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy. .,Department of Neurology, Stroke Unit, SS Annunziata Hospital, Chieti, Italy. .,Department of Neurology, Headache Center, SS Annunziata Hospital, Chieti, Italy.
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Abstract
PURPOSE This article provides an overview of a diverse group of primary headache disorders that are categorized in the International Classification of Headache Disorders, 3rd Edition (ICHD-3), as "other primary headache disorders." This article provides clinicians with a distilled understanding of the diagnoses and their epidemiology, pathophysiology, and management. RECENT FINDINGS Cough-induced headache requires neuroimaging to exclude posterior fossa pathology and recently has been reported as a common symptom in patients with CSF-venous fistula. Clinical overlap is observed between patients with primary exercise headache and primary headache associated with sexual activity. Patients with recurrent thunderclap headache associated with sexual activity should be presumed to have reversible cerebral vasoconstriction syndrome until proven otherwise. De novo external-pressure headache is a common sequela among health care workers using personal protective equipment during the COVID-19 pandemic. New daily persistent headache is an important mimicker of chronic migraine or chronic tension-type headache and is distinguished by a daily-from-onset progression of persistent headache; a treatment-refractory course is often observed, and early involvement of a multidisciplinary team, including a psychotherapist, is advised. SUMMARY Patients with primary headache disorders that are classified as "other primary headache disorders" have presentations with unique diagnostic and management considerations. The disorders are highly recognizable, and an appreciation of the diagnoses will aid clinicians in providing safe and effective care for patients presenting with headache.
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Liu H, Ran Y, Dang L, Yang R, Sun S, Zhang M, Li K, Chen C, Dong Z, Yu S. Clinical features and outcomes of new daily persistent headache in patients in China and comparison with medication overuse headache: a double-center retrospective study. PAIN MEDICINE 2021. [DOI: 10.31636/pmjua.v6i1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: This study examined the clinical features and outcomes of NDPH patients and comparison with medication-overuse headache (MOH) in Mainland China.
Methods: This retrospective study observed patients with NDPH and medication-overuse headache (MOH) visiting two outpatient clinics between November 2011 and December 2019. Clinical information was collected and all patients were followed by telephone.
Results: The study recruited 73 NDPH and 638 MOH patients. The NDPH patients included 39 males (39/73, 53.4%) and 34 females (34/73, 46.6%), with an average age of 37.4 years and average headache duration of 10.6 years. Headache-precipitating factors included infection (11/73, 15.1%) and stress (22/73, 30.1%). Compared to MOH patients, NDPH patients had a male predominance (53.4% vs. 22.6%, p<0.001), younger age of CDH onset (26.7±12.3 vs. 41.4±11.3 years, p<0.001), and longer duration of CDH (10.6±11.8 vs. 6.1±6.2 years, p=0.023). In 62 NDPH patients followed up for 31 months, on average, therapeutic responses were more effective in NDPH patients with trigger factors than in those without trigger factors (71.4% vs. 32.4%; p = 0.002); the odds ratio (OR) of an effective outcome was 5.25 (1.73–17.84, p = 0.005).
Conclusions: NDPH is significantly different from MOH, with a male predominance, younger age of CDH onset, and longer duration of CDH. The presence of trigger factors is an independent predictor of better treatment effect in NDPH patients.
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Papetti L, Sforza G, Tarantino S, Moavero R, Ruscitto C, Ursitti F, Ferilli MAN, Vigevano F, Valeriani M. Features and Management of New Daily Persistent Headache in Developmental-Age Patients. Diagnostics (Basel) 2021; 11:diagnostics11030385. [PMID: 33668316 PMCID: PMC7996357 DOI: 10.3390/diagnostics11030385] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 11/26/2022] Open
Abstract
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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Affiliation(s)
- Laura Papetti
- Department of Neuroscience, Paediatric Headache Center, Bambino Gesù Children Hospital, 00165 Rome, Italy; (L.P.); (G.S.); (S.T.); (R.M.); (F.U.); (M.A.N.F.)
| | - Giorgia Sforza
- Department of Neuroscience, Paediatric Headache Center, Bambino Gesù Children Hospital, 00165 Rome, Italy; (L.P.); (G.S.); (S.T.); (R.M.); (F.U.); (M.A.N.F.)
| | - Samuela Tarantino
- Department of Neuroscience, Paediatric Headache Center, Bambino Gesù Children Hospital, 00165 Rome, Italy; (L.P.); (G.S.); (S.T.); (R.M.); (F.U.); (M.A.N.F.)
| | - Romina Moavero
- Department of Neuroscience, Paediatric Headache Center, Bambino Gesù Children Hospital, 00165 Rome, Italy; (L.P.); (G.S.); (S.T.); (R.M.); (F.U.); (M.A.N.F.)
- Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, 00133 Rome, Italy;
| | - Claudia Ruscitto
- Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, 00133 Rome, Italy;
| | - Fabiana Ursitti
- Department of Neuroscience, Paediatric Headache Center, Bambino Gesù Children Hospital, 00165 Rome, Italy; (L.P.); (G.S.); (S.T.); (R.M.); (F.U.); (M.A.N.F.)
| | - Michela Ada Noris Ferilli
- Department of Neuroscience, Paediatric Headache Center, Bambino Gesù Children Hospital, 00165 Rome, Italy; (L.P.); (G.S.); (S.T.); (R.M.); (F.U.); (M.A.N.F.)
| | - Federico Vigevano
- Department of Neuroscience, Neurology Unit, Bambino Gesù Children Hospital, 00165 Rome, Italy;
| | - Massimiliano Valeriani
- Department of Neuroscience, Paediatric Headache Center, Bambino Gesù Children Hospital, 00165 Rome, Italy; (L.P.); (G.S.); (S.T.); (R.M.); (F.U.); (M.A.N.F.)
- Center for Sensory-Motor Interaction, Aalborg University, 9220 Aalborg, Denmark
- Correspondence: ; Tel.: +39-066-859-2289
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28
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Rozen TD. Daily persistent headache after a viral illness during a worldwide pandemic may not be a new occurrence: Lessons from the 1890 Russian/Asiatic flu. Cephalalgia 2020; 40:1406-1409. [PMID: 33146034 PMCID: PMC7645599 DOI: 10.1177/0333102420965132] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
New daily persistent headache was first documented in the medical literature in the 1980s. The leading trigger is a viral illness. As we navigate our way thru the current SARS-CoV-2 pandemic, looking back at past viral epidemics may help guide us for what to expect in the near future in regard to headaches as a persistent manifestation of the SARS-CoV-2 infection. The 1890 viral pandemic known as the “Russian or Asiatic flu”, has extensive documentation about the neurologic sequelae that presented months to years after the pandemic ended. One of the complications was daily persistent headache. There are actually many similarities between the viral presentation of the 1890 pandemic and the current SARS-CoV-2 pandemic, which may then suggest that not only will NDPH be part of the neurological sequelae but a possible key consequence of the SARS-CoV-2 infection.
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29
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Lagrata S, Cheema S, Watkins L, Matharu M. Long-Term Outcomes of Occipital Nerve Stimulation for New Daily Persistent Headache With Migrainous Features. Neuromodulation 2020; 24:1093-1099. [PMID: 32996695 DOI: 10.1111/ner.13282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/04/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES New daily persistent headache (NDPH) is a subset of chronic headache where the pain is continuous from onset. Phenotypically it has chronic migraine or chronic tension type features. NDPH is considered to be highly refractory. Occipital nerve stimulation (ONS) has been used for treatment of refractory chronic migraine but there are no specific reports of its use for NDPH with migrainous features. MATERIALS AND METHODS Nine patients with NDPH with migrainous features were identified as having had ONS implants between 2007 and 2014 in a specialist unit with experience of using ONS in chronic migraine. Moderate to severe headache days were compared at baseline and follow-up. A positive response was defined as at least 30% reduction in monthly moderate to severe headache days. RESULTS Patients had suffered NDPH for a median of 8 years (range 3-16 years) and had failed a median of 11 previous treatments (range 8-15). After a median follow-up of 53 months (range 27-108 months), only a single patient showed a positive response to ONS. At no point did the cohort as a whole show any change in monthly moderate to severe headache days or disability scores. CONCLUSION Our experience suggests that ONS is not effective in the treatment of NDPH with migrainous features even in centers with experience in treating chronic migraine with ONS. The difference in response rates of chronic migraine and NDPH with migrainous features supports the concept of a different pathophysiology to the two conditions.
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Affiliation(s)
- Susie Lagrata
- Headache and Facial Pain Group, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - Sanjay Cheema
- Headache and Facial Pain Group, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - Laurence Watkins
- Department of Neurosurgery, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
| | - Manjit Matharu
- Headache and Facial Pain Group, UCL Queen Square Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK
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30
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Stubberud A, Cheema S, Tronvik E, Matharu M. Nutcracker syndrome mimicking new daily persistent headache: A case report. Cephalalgia 2020; 40:1008-1011. [PMID: 32295399 PMCID: PMC7691626 DOI: 10.1177/0333102420918554] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Compression of the duodenum and left renal vein between the aorta and superior mesenteric artery usually leads to symptoms of proximal bowel obstruction or hematuria and, more rarely, nonspecific mild headaches. CASE A young woman presented with new daily persistent headache refractory to numerous pharmacological treatments, onabotulinumtoxinA, nerve blocks, and occipital nerve stimulation. Following several years of daily severe headache, worsening abdominal pain and intolerance for food intake led to the discovery of aortomesenteric compression. Surgical treatment gave prompt improvement in gastric symptoms but also essentially resolved the headache. CONCLUSION This is the first description of new daily persistent headache in association with aortomesenteric compression as well as marked improvement of headache following aortomesenteric decompression. In patients with new daily persistent headache and orthostatic symptoms one may consider a differential diagnosis of Nutcracker syndrome, especially in patients with comorbid hypermobility syndromes, hematuria or gastric symptoms.
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Affiliation(s)
- Anker Stubberud
- Headache and Facial Pain Group, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Department of Neuromedicine and Movement Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Sanjay Cheema
- Headache and Facial Pain Group, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Erling Tronvik
- Department of Neuromedicine and Movement Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology, St. Olavs Hospital, Trondheim, Norway
| | - Manjit Matharu
- Headache and Facial Pain Group, UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, United Kingdom
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Schnall R, Liu J, Reame N. Ecological momentary assessment of HIV versus reproductive health symptoms in women of differing reproductive stages living with HIV. Menopause 2019; 26:1375-1384. [PMID: 31567866 PMCID: PMC6893076 DOI: 10.1097/gme.0000000000001404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To what extent menopause is related to symptom burden in women living with HIV (WLWH) is unclear, as a specific reproductive health analysis has seldom been undertaken, in part due to an inadequate assessment of reproductive status. The purpose of this study was to document and compare symptom frequency and attribution over 46 days and examine differences by reproductive status with a sample of 75 WLWH. METHODS We conducted an ecological momentary assessment using text messaging to follow 75 women confirmed for menopause stage with hormone profiles for 46 days. Participants were asked to respond to the following open-ended questions via a text message 3× weekly: (1) Did you have your period today? (Yes/No) (2) What were your top three menstrual/menopausal symptoms today? (3) What were your top three HIV-related symptoms today? RESULTS A total of 73 women (mean± SD age = 51 ± 8 y, range= 24-67 y) completed the study (10 pre-, 20 peri-, and 43 postmenopause). The majority of volunteers were black non-Hispanic (74%), nonsmokers (61%), with some high school (68%) and reporting <$20,000 annual income. After controlling for cofactors, HIV symptom profiles differed by menopause stage: postmenopause predicted more fatigue, muscle aches and pains, nausea/vomiting, and diarrhea (vs peri- or premenopause). HIV-related depression was predicted by the peristage. For reproductive symptoms, women endorsed fatigue (58%), hot flashes (52%), depression (49%), and muscle aches and pains (44%) as most common, but of these, only muscle aches and pains demonstrated group differences in period prevalence (post = 35%; peri = 45%; pre = 80%, P= 0.03) Surprisingly, hot flash frequency was similar, but fever/chills/sweats varied across menopause stage (period prevalence: post=42%; peri=15%; pre=0%, P=0.01). Reporting "a period today" predicted the profile of reproductive symptoms, but was not related to HIV symptoms. CONCLUSIONS Although fatigue, muscle aches/pains and depression are perceived as common attributes of both HIV infection and reproductive status in WLWH, they distinguish condition-specific symptom profiles that are dependent on menopause stage.
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Affiliation(s)
| | - Jianfang Liu
- Columbia University School of Nursing, New York, NY,
USA
| | - Nancy Reame
- Columbia University School of Nursing, New York, NY,
USA
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Palacios‐Ceña D, Talavera B, Gómez‐Mayordomo V, García‐Azorín D, Gallego‐Gallego M, Guerrero ÁL, Cuadrado M. The Day My Life Changed: A Qualitative Study of the Experiences of Patients With New Daily Persistent Headache. Headache 2019; 60:124-140. [DOI: 10.1111/head.13712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Domingo Palacios‐Ceña
- Department of Physical Therapy Occupational Therapy, Rehabilitation and Physical Medicine Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS) Universidad Rey Juan Carlos Alcorcón Spain
| | - Blanca Talavera
- Headache Unit Department of Neurology Hospital Clínico Universitario de Valladolid Valladolid Spain
| | - Víctor Gómez‐Mayordomo
- Headache Unit Department of Neurology Hospital Clínico San Carlos Instituto de Investigación Sanitaria San Carlos (IdISSC) Madrid Spain
| | - David García‐Azorín
- Headache Unit Department of Neurology Hospital Clínico Universitario de Valladolid Valladolid Spain
| | | | - Ángel L. Guerrero
- Headache Unit Department of Neurology Hospital Clínico Universitario de Valladolid Valladolid Spain
- Institute of Biomedical Research of Salamanca (IBSAL) Salamanca Spain
| | - María‐Luz Cuadrado
- Headache Unit Department of Neurology Hospital Clínico San Carlos Instituto de Investigación Sanitaria San Carlos (IdISSC) Madrid Spain
- Department of Medicine School of Medicine Universidad Complutense de Madrid Madrid Spain
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Rozen TD. The Three T's of NDPH (How Clinical Observations Have Led to Improved Treatment Outcomes). Headache 2019; 59:1401-1406. [DOI: 10.1111/head.13624] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Todd D. Rozen
- Department of Neurology Mayo Clinic Florida Jacksonville FL USA
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Yamani N, Olesen J. New daily persistent headache: a systematic review on an enigmatic disorder. J Headache Pain 2019; 20:80. [PMID: 31307396 PMCID: PMC6734284 DOI: 10.1186/s10194-019-1022-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 06/10/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND New daily persistent headache (NDPH) presents with a sudden onset headache which continues without remission within 24 h. Although rare, NDPH is important because it is one of the most treatment refractory primary headache disorders and can be highly disabling to the individuals. In this structured review, we describe the current knowledge of epidemiology, clinical features, trigger factors, pathophysiology, diagnosis and therapeutic options of NDPH to better understand this enigmatic disorder. The prevalence of NDPH estimated to be 0.03% to 0.1% in the general population and is higher in children and adolescents than in adults. Individuals with NDPH can pinpoint the exact date their headache started. The pain is constant and lacks special characteristics but in some has migraine features. The exact pathogenic mechanism of NDPH is unknown, however pro-inflammatory cytokines and cervicogenic problems might play a role in its development. The diagnosis of NDPH is mainly clinical and based on a typical history, but proper laboratory investigation is needed to exclude secondary causes of headache. Regarding treatment strategy, controlled drug trials are absent. It is probably best to treat NDPH based upon the predominant headache phenotype. For patients who do not respond to common prophylactic drugs, ketamine infusion, onabotulinum toxin type A, intravenous (IV) lidocaine, IV methylprednisolone and nerve blockade are possible treatment options, but even aggressive treatment is usually ineffective. CONCLUSION NDPH remains poorly understood but very burdensome for the individual. Multi-center randomized controlled trials are recommended to gain better understanding of NDPH and to establish evidence based treatments.
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Affiliation(s)
- Nooshin Yamani
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Danish Headache Centre and Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Copenhagen, Denmark.
| | - Jes Olesen
- Danish Headache Centre and Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Copenhagen, Denmark
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35
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Cianchetti C. New Daily Persistent Headache? Comment on “Pediatric Headache and Sleep Disturbance: A Comparison of Diagnostic Groups”. Headache 2019; 59:619-620. [DOI: 10.1111/head.13509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Carlo Cianchetti
- Child and Adolescent NeuroPsychiatry University of Cagliari Cagliari Italy
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36
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Riddle EJ, Smith JH. New Daily Persistent Headache: a Diagnostic and Therapeutic Odyssey. Curr Neurol Neurosci Rep 2019; 19:21. [DOI: 10.1007/s11910-019-0936-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Jamali SA, Rozen TD. An RCVS Spectrum Disorder? New Daily Persistent Headache Starting as a Single Thunderclap Headache (3 New Cases). Headache 2019; 59:789-794. [PMID: 30830966 DOI: 10.1111/head.13495] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2019] [Indexed: 02/04/2023]
Affiliation(s)
| | - Todd D. Rozen
- Department of Neurology Mayo Clinic Florida Jacksonville FL USA
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38
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Smith JH. Enduring phenotype of episodic status migrainosus in a prospectively identified patient. CEPHALALGIA REPORTS 2018. [DOI: 10.1177/2515816318815226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Episodic status migrainosus is a previously described migraine variant where the exclusive phenotype is that of relapsing status migrainosus. The majority of cases have been reported based on retrospective chart review. A prospectively identified case fulfilling previously published criteria for episodic status migrainosus is reported, with an enduring pattern of attacks meeting criteria for status migrainosus over a 35-year period. A family history in a maternal aunt of a similar phenotype was noted. This prospectively identified case further validates the existence of episodic status migrainosus as a novel nosologic entity. The family history in our case suggests the possibility of genetic susceptibility. Perspective regarding a potential temporal continuum between acute migraine, status migrainosus, and new daily persistent headache is described. Status migrainosus may occur both as a complication of migraine and in the pure form of episodic status migrainosus.
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Rozen TD. New daily persistent headache (NDPH) triggered by a single Valsalva event: A case series. Cephalalgia 2018; 39:785-791. [PMID: 30301379 DOI: 10.1177/0333102418806869] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe a new subtype of new daily persistent headache that is triggered by a single Valsalva event. METHODS A case series of patients was evaluated in an academic headache clinic over a 3-year time period. RESULTS A total of seven patients (four female and three male) were diagnosed with this new subtype of new daily persistent headache. The headaches all began after a single Valsalva event. Average age at time of headache onset was 41 years (males: 39 years; females: 43 years) with an age range of 20-62 years. All patients developed their syndrome during the months of September to February with November and February being the most cited months (5/7 patients). Immediate worsening in the Trendelenburg position occurred in all patients and appeared to be an almost diagnostic test for the syndrome. No patient had papilledema on funduscopic exam. Five out of seven patients had no prior headache history including cough, exercise or migraine. Four of seven patients were of normal weight, while one was overweight and two were obese. A crowded posterior fossa was identified in five of seven patients on brain MRI. On cerebrospinal fluid pressure/volume lowering medication (acetazolamide, indomethacin and/or spironolactone), five out of seven patients achieved 90% plus improvement in headache frequency while three patients became pain free. Three patients were able to taper off medication without headache recurrence. CONCLUSION New daily persistent headache after a single Valsalva event appears to be a unique subtype of new daily persistent headache that is responsive to cerebrospinal fluid pressure/volume lowering medications. An abnormal reset of cerebrospinal fluid pressure/intracranial pressure to an elevated state is the presumed pathogenesis and may relate to the patient's baseline neuroanatomy of a crowded posterior fossa. There appears to be a circadian periodicity to the onset of the syndrome. Worsening in the Trendelenburg position is a probable diagnostic test. Defining new daily persistent headache subtypes by triggering event appears to be making a positive inroad in the understanding of this condition and helps present new effective therapies.
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Affiliation(s)
- Todd D Rozen
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
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Robbins MS, Vanast WJ, Purdy RA. New Daily Persistent Headache: Historical Review and an Interview with Dr. Walter Vanast. Headache 2017; 57:926-934. [DOI: 10.1111/head.13103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 03/08/2017] [Indexed: 01/03/2023]
Affiliation(s)
- Matthew S. Robbins
- Department of Neurology, Albert Einstein College of Medicine; Montefiore Headache Center; Bronx NY USA
| | - Walter J. Vanast
- Kateri Memorial Hospital Centre; Kahnawake Quebec Canada
- Department of Neurology and Neurosurgery; McGill University; Montreal Quebec Canada
| | - R. Allan Purdy
- Department of Medicine (Neurology); Dalhousie University; Halifax Nova Scotia Canada
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