Cdp

Chronic Daily Headache
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Headache occurring 15 or more days per month
Complications	Medication overuse headache, depression, anxiety
Onset	Gradual
Duration	Long-term
Types	N/A
Causes	Various, including migraine, tension-type headache, medication overuse
Risks	Overuse of headache medications, stress, sleep disorders
Diagnosis	N/A
Differential diagnosis	N/A
Prevention	N/A
Treatment	Lifestyle modification, medication, cognitive behavioral therapy
Medication	N/A
Prognosis	Variable
Frequency	Common
Deaths	N/A

Chronic Daily Headache (CDH) is a term used to describe a group of headache disorders that occur on 15 or more days per month for more than three months. CDH is not a specific type of headache but rather a category that includes several different headache types. It is a significant cause of disability and reduced quality of life.

Classification

Chronic daily headache can be classified into primary and secondary types. Primary CDH includes:

• Chronic migraine
• Chronic tension-type headache
• New daily persistent headache
• Hemicrania continua

Secondary CDH may result from:

• Medication overuse headache
• Head trauma
• Infection
• Intracranial hypertension

Pathophysiology

The pathophysiology of chronic daily headache varies depending on the underlying type of headache. In chronic migraine, there is often a genetic predisposition combined with environmental triggers that lead to changes in the brainstem and its interaction with the trigeminal nerve pathways. Chronic tension-type headache may involve muscle tension and stress-related mechanisms.

Medication overuse headache is thought to result from the frequent use of headache medications, which can lead to changes in pain pathways and increased headache frequency.

Risk Factors

Several risk factors are associated with the development of chronic daily headache, including:

• Overuse of acute headache medications
• High levels of stress
• Poor sleep quality or sleep disorders
• Obesity
• Depression and anxiety

Diagnosis

The diagnosis of chronic daily headache is primarily clinical, based on the patient's history and symptomatology. A thorough history should include the frequency, duration, and characteristics of the headaches, as well as any associated symptoms. A physical and neurological examination is essential to rule out secondary causes of headache.

Management

Management of chronic daily headache involves a combination of lifestyle modifications, pharmacological treatments, and behavioral therapies.

Lifestyle Modifications

Patients are advised to maintain a regular sleep schedule, engage in regular physical activity, and manage stress through techniques such as mindfulness or yoga.

Pharmacological Treatments

Preventive medications may include:

• Antidepressants such as amitriptyline
• Anticonvulsants like topiramate
• Beta-blockers such as propranolol

For medication overuse headache, a gradual withdrawal of the overused medication is recommended.

Behavioral Therapies

Cognitive behavioral therapy (CBT) can be effective in managing chronic daily headache by helping patients develop coping strategies and reduce stress.

Prognosis

The prognosis for chronic daily headache varies. Some patients experience significant improvement with appropriate treatment, while others may continue to have frequent headaches. Early intervention and a comprehensive treatment plan can improve outcomes.

See Also

• Migraine
• Tension-type headache
• Cluster headache

External Links

• National Headache Foundation
• American Migraine Foundation

Classification
External resources