However, in spite of the presence of migrainous symptoms, NDPH is still defined as a headache and has headache-related symptoms. Patients with NDPH report that pain is typically felt across the head bilaterally. This is different from a migraine, where pain is felt on only one side of the head. The pain is also typically pressing or tightening in quality, which is characteristic of a typical headache (Prakash & Shah, 2010). However, this pain is starkly different from a normal headache because it is continuous and does not stop from the time the headache began. This is one of the most defining aspects of NDPH symptoms: they do not let up at any time in at least 80% of patients, one study found, and they are inescapable, though severity may
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These patients record anything unusual or possible dangerous that happened to them in the days or hours before their symptoms began, which they may do fairly accurately because most NDPH patients have a distinct and clearly remembered onset. Using this retrospective method, nearly half of patients responded that they did not have any kind of recognized trigger. One study found that between 40% and 60% of patients did not have a determinable cause for their symptoms (Rozen, 2011). This data was confirmed more recently by Rozen (2015), who found that 53% of subjects with NDPH had no recognizable trigger, further deepening concern over the problem that is new daily persistent headache. The mystery of NDPH does not end with those patients who have unknown triggers, however. No single cause has been found to cause the majority of NDPH cases, and those who identify a trigger have multiple theories. One of the most prevalently identified trigger for NDPH is an infection of some sort, often a flu-like virus. Studies have shown between 22% and 30% of NDPH patients recognize some kind of infection which may have triggered the onset of the syndrome, and one theory points to the Epstein-Barr Virus (EBV) as a possible perpetrator (Rozen, 2015; Li & Rozen 2002). In fact, in one group 85% of patients with NDPH were found to have the active EBV in their systems (Rozen 2011). It is unknown how EBV may cause pain and other symptoms of NDPH, but the correlation has been identified. Other common theories of triggers of NDPH include onset after a surgical procedure of a stressful life event. Surgical procedures were cited by 9% of patients in one study as a trigger. Surprisingly, most patients who cite surgery did not undergo a procedure that involved the head or nervous system, so the surgery should not have caused
These patients record anything unusual or possible dangerous that happened to them in the days or hours before their symptoms began, which they may do fairly accurately because most NDPH patients have a distinct and clearly remembered onset. Using this retrospective method, nearly half of patients responded that they did not have any kind of recognized trigger. One study found that between 40% and 60% of patients did not have a determinable cause for their symptoms (Rozen, 2011). This data was confirmed more recently by Rozen (2015), who found that 53% of subjects with NDPH had no recognizable trigger, further deepening concern over the problem that is new daily persistent headache. The mystery of NDPH does not end with those patients who have unknown triggers, however. No single cause has been found to cause the majority of NDPH cases, and those who identify a trigger have multiple theories. One of the most prevalently identified trigger for NDPH is an infection of some sort, often a flu-like virus. Studies have shown between 22% and 30% of NDPH patients recognize some kind of infection which may have triggered the onset of the syndrome, and one theory points to the Epstein-Barr Virus (EBV) as a possible perpetrator (Rozen, 2015; Li & Rozen 2002). In fact, in one group 85% of patients with NDPH were found to have the active EBV in their systems (Rozen 2011). It is unknown how EBV may cause pain and other symptoms of NDPH, but the correlation has been identified. Other common theories of triggers of NDPH include onset after a surgical procedure of a stressful life event. Surgical procedures were cited by 9% of patients in one study as a trigger. Surprisingly, most patients who cite surgery did not undergo a procedure that involved the head or nervous system, so the surgery should not have caused