BackgroundNew 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.Main body of the abstractThe 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.ConclusionNDPH 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.

中文翻译：

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新的每日持续性头痛：对一种神秘疾病的系统评价

背景新的每日持续性头痛 (NDPH) 表现为突然发作的头痛，在 24 小时内持续无缓解。虽然罕见，但 NDPH 很重要，因为它是最难治疗的原发性头痛疾病之一，并且可能对个人造成高度残疾。在这篇结构化的综述中，我们描述了 NDPH 的流行病学、临床特征、触发因素、病理生理学、诊断和治疗选择的当前知识，以更好地了解这种神秘的疾病。摘要的主体 NDPH 的患病率估计为 0.03% 至 0.1%在一般人群中，儿童和青少年高于成人。患有 NDPH 的人可以确定他们头痛开始的确切日期。疼痛是持续的，没有特殊的特征，但在某些情况下有偏头痛的特征。NDPH 的确切发病机制尚不清楚，但促炎细胞因子和宫颈源问题可能在其发展中发挥作用。NDPH 的诊断主要基于临床并基于典型病史，但需要进行适当的实验室检查以排除头痛的继发性原因。关于治疗策略，缺乏对照药物试验。根据主要的头痛表型来治疗 NDPH 可能是最好的。对于对常用预防药物无反应的患者，氯胺酮输注、A 型肉毒杆菌毒素、静脉注射 (IV) 利多卡因、IV 甲基强的松龙和神经阻滞剂是可能的治疗选择，但即使积极治疗通常也无效。结论 NDPH 仍然知之甚少，但负担很大对于个人。