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ABN Abstracts 2022
Poster presentations
008 Is primary new daily persistent headache de novo chronic migraine and chronic tension-type headache?
  1. Sanjay Cheema1,
  2. Anker Stubberud1,2,4,
  3. Khadija Rantell3,
  4. Parashkev Nachev2,
  5. Erling Tronvik4,
  6. Manjit Matharu1
  1. 1Headache and Facial Pain Group, UCL Queen Square Institute of Neurology, London, UK
  2. 2High Dimensional Neurology Group, UCL Queen Square Institute of Neurology, London, UK
  3. 3Education Unit, UCL Queen Square Institute of Neurology, London, UK
  4. 4Department of Neuromedicine and Movement Sciences, NTNU Norwegian University of Science and Technology

Abstract

Objective To compare the clinical characteristics and treatment responses of primary new daily persis- tent headache (NDPH) to transformed chronic daily headache (T-CDH, encompassing chronic migraine and chronic tension-type headache).

Methods Analysis of prospectively collected clinical data in consecutive patients seen in a headache clinic between 2007 and 2019.

Results Inclusion criteria were met by 366 patients with NDPH and 696 with T-CDH. There was a lower female preponderance in NDPH than T-CDH (62.6% vs. 73.3%, p <0.001).

Nausea, vomiting, photophobia, phonophobia, motion sensitivity, vertigo, and cranial autonomic symptoms were all less common in NDPH than T-CDH (all p<0.001). Most T-CDH patients (85%) met ICHD-3 criteria for chronic migraine, whereas fewer NDPH patients did (64%).

Acute treatments were less effective in NDPH, and medication overuse was less common (16% vs. 42%, p<0.001). Response to most classes of oral preventive treatments was poor. The most effective treatment in NDPH was doselupin in 45.7% patients (95% CI 34.8-56.5%). OnabotulinumtoxinA was less likely to be effective in NDPH than T-CDH (34% vs. 49%, p=0.003).

Conclusions Whilst there is overlap in the phenotype and response to treatment of NDPH and T-CDH; NDPH appears to be less symptomatically diverse, and less responsive to treatment.

https://doi.org/10.1136/jnnp-2022-abn2.52

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