Post-infectious new daily persistent headache may respond to intravenous methylprednisolone

The Journal of Headache and Pain

Original

Sanjay Prakash¹  Nilima D. Shah² 

[1] Department of Neurology, Medical College, SSG Hospital, 390001, Baroda, Gujarat, India;O-19, Doctor’s Quarter, Jail Road, 390001, Baroda, Gujarat, India;Department of Psychiatry, Medical College, 390001, Baroda, Gujarat, India;

关键词: Headache;    New daily persistent headache;    Chronic daily headache;    Post infectious illness;    Corticosteroids;    Methyl prednisolone;   

DOI  :  10.1007/s10194-009-0171-x

 received in 2009-09-21, accepted in 2009-10-27,  发布年份 2009

来源: Springer

【 摘 要 】

New daily persistent headache (NDPH) is a subtype of chronic daily headache (CDH) that starts acutely and continues as a daily headache from the onset. It is considered as one of the most treatment refractory of all headache syndromes. The pathophysiology is largely unknown. Viral infections, extracranial surgery, and stressful life events are considered as triggers for the onset of NDPH. A few patients may have the onset of their symptoms during an infection. Here we report nine patients with NDPH like headache. All of them had a history suggestive of extracranial infections a few weeks prior to the onset of headache. All patients received intravenous methyl prednisolone (IV MPS) for 5 days. Intravenous MPS was followed by Oral steroids for 2–3 weeks in six patients. The relief of headache started between the second and fifth days of infusion in all patients. The steady improvement in headache continued and seven patients experienced almost complete improvement within 2 weeks. Two other patients showed complete improvement between 6 and 8 weeks after initiation of IV MPS therapy. We conclude that NDPH-like headache may occur as a post infectious process following a recent infection. We also speculate on the possible mechanisms of headache in our patients.

【 授权许可】

Unknown   
© Springer-Verlag 2009