Clinical and prognostic subforms of new daily-persistent headache
Clinical and prognostic subforms of new daily-persistent headache
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DOI：
10.1212/wnl.0b013e3181dad5de
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发表时间：
2010-04-27
期刊：
影响因子：
9.9
通讯作者：
Lipton, R. B.
中科院分区：
文献类型：
--
作者：
Robbins, M. S.;Grosberg, B. M.;Lipton, R. B.
背景资料：根据国际头痛疾病分类（ICHD）-2，原发性每日头痛从发病开始就不间断，只有当偏头痛特征不存在时才被归类为新发每日持续性头痛（NDPH）。当偏头痛的功能是本，分类是problemptued.Methods：我们制定了一个修订的NDPH定义不排除偏头痛的功能（NDPH-R），并将其应用于连续的病人看到在蒙特菲奥里头痛中心。我们将这组患者分为符合ICHD-2标准的患者（NDPH-ICHD）和那些有太多ICHD-2偏头痛特征的患者（NDPH-mf）。我们比较了这些组的临床和人口统计学特征，确定了3个预后亚组：持续性、缓解性和复发缓解性。结果：71例NDPH-R患者中，31例（43.7%）同时符合NDPH-ICHD-2标准。NDPH-mf组和NDPH-ICHD-2组在大多数临床特征上相似，尽管NDPH-mf组更年轻，包括更多女性，并且抑郁症发生率更高。两组在异常性疼痛的患病率、曲坦反应性和预后方面相似。NDPH-R的预后亚型也非常相似，虽然持续的亚型更有可能是白色种族，有焦虑或抑郁，并有一个年轻的发病年龄。结论：目前的国际头痛疾病分类（ICHD）-2标准排除了大多数原发性头痛从发病持续的患者。修订后的新的每日持续性头痛定义不排除偏头痛特征（NDPH-R）的拟议标准将这些患者根据人口统计学、临床特征和预后分为相对同质的组。新发每日持续性头痛伴太多ICHD-2偏头痛特征和符合ICHD-2标准的新发每日持续性头痛均包括相同比例的患者，这些患者属于持续性、缓解性和复发缓解性亚组。我们的NDPH-R标准应考虑纳入ICHD-3。神经病学（R）2010; 74：1358-1364
Background: According to the International Classification of Headache Disorders (ICHD)-2, primary daily headaches unremitting from onset are classified as new daily-persistent headache (NDPH) only if migraine features are absent. When migraine features are present, classification is problematic.Methods: We developed a revised NDPH definition not excluding migraine features (NDPH-R), and applied it to consecutive patients seen at the Montefiore Headache Center. We divided this group into patients meeting ICHD-2 criteria (NDPH-ICHD) and those with too many migraine features for ICHD-2 (NDPH-mf). We compared clinical and demographic features in these groups, identifying 3 prognostic subgroups: persisting, remitting, and relapsing-remitting. Remitting and relapsing-remitting patients were combined into a nonpersisting group.Results: Of 71 NDPH-R patients, 31 (43.7%) also met NDPH-ICHD-2 criteria. The NDPH-mf and the NDPH-ICHD-2 groups were similar in most clinical features though the NDPH-mf group was younger, included more women, and had a higher frequency of depression. The groups were similar in the prevalence of allodynia, triptan responsiveness, and prognosis. NDPH-R prognostic subforms were also very similar, although the persisting subform was more likely to be of white race, to have anxiety or depression, and to have a younger onset age.Conclusions: Current International Classification of Headache Disorders (ICHD)-2 criteria exclude the majority of patients with primary headache unremitting from onset. The proposed criteria for revised new daily-persistent headache definition not excluding migraine features (NDPH-R) classify these patients into a relatively homogeneous group based on demographics, clinical features, and prognosis. Both new daily-persistent headache with too many migraine features for ICHD-2 and new daily-persistent headache meeting ICHD-2 criteria include patients in equal proportions that fall into the persisting, remitting, and relapsing-remitting subgroups. Our criteria for NDPH-R should be considered for inclusion in ICHD-3. Neurology (R) 2010; 74: 1358-1364