Introduction:

New daily persistent headache (NDPH) is a primary headache disorder characterized by an intractable, daily, and unremitting headache lasting for at least 3 months. Currently, there are limited studies in the pediatric population describing the characteristics of NDPH.

Objective:

The objective of the current study is to describe the characteristics of NDPH in pediatric patients presenting to a headache program at a tertiary referral center.

Methods:

The participants in the current study were pediatric patients who attended the Headache Clinic at Children’s National Hospital between 2016 and 2018. All patients seen in the Headache Clinic were enrolled in an institutional review board–approved patient registry.

Results:

Between 2016 and 2018, NDPH was diagnosed in 245 patients, representing 14% of the total headache population. NDPH patients were predominantly female (78%) and white (72%). The median age was 14.8 years. The median pain intensity was 6 of 10 (standard deviation = 1.52). Most patients reported experiencing migrainous features, namely, photophobia (85%), phonophobia (85%), and a reduced activity level (88%). Overall, 33% of patients had failed at least 1 preventive medication, and 56% had failed at least 1 abortive medication. Furthermore, 36% of patients were additionally diagnosed with medication overuse headache.

Conclusion:

NDPH is a relatively frequent disorder among pediatric chronic headache patients. The vast majority of these patients experience migrainous headache characteristics and associated symptoms and are highly refractory to treatment—as evidenced by a strong predisposition to medication overuse headache and high rates of failed preventive management.

中文翻译：

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儿科人群中新的每日持续性头痛

介绍：

新的每日持续性头痛 (NDPH) 是一种原发性头痛疾病，其特征是持续至少 3 个月的顽固性、每日和持续性头痛。目前，描述 NDPH 特征的儿科人群研究有限。

客观的：

本研究的目的是描述在三级转诊中心接受头痛项目的儿科患者 NDPH 的特征。

方法：

本研究的参与者是 2016 年至 2018 年间在国立儿童医院头痛诊所就诊的儿科患者。在头痛诊所就诊的所有患者都被纳入机构审查委员会批准的患者登记处。

结果：

2016 年至 2018 年间，245 名患者被诊断为 NDPH，占总头痛人群的 14%。NDPH 患者主要是女性 (78%) 和白人 (72%)。中位年龄为 14.8 岁。中位疼痛强度为 10 分中的 6 分（标准差 = 1.52）。大多数患者报告出现偏头痛特征，即畏光（85%）、畏声（85%）和活动水平降低（88%）。总体而言，33% 的患者至少 1 次预防性药物治疗失败，56% 的患者至少 1 次无效药物治疗失败。此外，36% 的患者还被诊断为药物过度使用性头痛。

结论：

NDPH 是小儿慢性头痛患者中相对常见的疾病。这些患者中的绝大多数都经历了偏头痛的特征和相关症状，并且对治疗高度难治——药物过度使用性头痛的强烈倾向和预防性管理失败率高就证明了这一点。