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Reader's Mail: Daily Persistent Headache Creates Challenges, but Treatment Options Exist

Q. My wife is suffering from a headache that has lasted for four years. She’s tried dozens of different medications, none of which give her any relief. At first, her doctors suspected she had migraine, but they eventually determined that wasn’t the case. Then they said it was a “dead nerve” and gave her an injection, which did not change anything. If medical practitioners suspect a nerve issue is involved, could they do a nerve block to see if they are correct?

A. It is possible that your wife may be suffering from new daily persistent headache (NDPH). This is a headache that starts one day and never goes away. Most sufferers can even recall the exact day the headache started and have experienced daily headaches since that time. It typically occurs in a person with no past history of headache.

NDPH is extremely difficult to treat but occasionally will respond to some of the daily preventive medications we use for very frequent migraine and tension-type headaches. Should these treatments fail, I have had occasional success in treating this condition with greater occipital nerve blocks or with Botox. In fact, the discussion of a “dead nerve” makes me suspect that your wife’s physician was considering deadening the nerve with a nerve block.

Although NDPH can be difficult to treat, your wife should not give up. The treatments mentioned above are occasionally helpful and should be given a chance.

Ira M. Turner, M.D.
The Center for Headache Care and Research, Island Neurological Associates, PC
Plainview, N.Y

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