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新发每日持续性头痛

Authors
Ivan Garza, MD
Todd J Schwedt, MD, MSCI
Section Editor
Jerry W Swanson, MD, MHPE
Deputy Editor
John F Dashe, MD, PhD
Translators
冯慧宇, 副主任医师

引言

慢性每日头痛是一种描述性术语，它包括几种不同的具体头痛诊断，均以频繁头痛为特征。每次头痛持续时间长(即持续至少4小时)的慢性每日头痛类型包括：慢性偏头痛、慢性紧张型头痛、药物过度使用性头痛、连续性半侧颅痛和新发每日持续性头痛(new daily persistent headache, NDPH)。 (参见“慢性每日头痛概述”)

NDPH综合征独有的特点是头痛在某一天开始发作，并且通常不会缓解。许多患者都可准确地描述其头痛开始的确切日期。NDPH于1986年首次被报道，将其描述为一种良性的慢性每日头痛，即使不治疗也会随着时间推移而改善[1]。然而，在其他研究以及实践中发现，NDPH可持续多年甚至数十年，且非常难治。

本专题将讨论NDPH。其他类型的慢性每日头痛见其他专题。 (参见“慢性每日头痛概述”)

病理生理学

目前对NDPH的病理生理学知之甚少。一些(但并非所有)报道提示，NDPH的发作可由某些事件触发。一项病例系列研究纳入56例患者，NDPH发病时合并有感染或流感样疾病、颅外手术，或有压力的生活事件的比例分别为30%、12%和12%[2]。在40例NDPH儿童中，头痛发作时合并有感染、轻微头部创伤、特发性颅内压增高(idiopathic intracranial hypertension, IIH)和手术的比例分别为43%、40%、10%和10%[3]。然而，日本的一项病例系列研究纳入30例青少年和成人患者，80%的患者没有明确的诱发因素[4]。

观察到头痛发作与感染或流感样疾病相关，引发了人们关注可能的微生物病因。然而，病毒或其他感染在NDPH发病机制(如果有的话)中的可能作用仍有待确定。

                

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Literature review current through: 2017-06 . | This topic last updated: 2016-05-23.
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