Daily persistent headache after viral illness during a worldwide pandemic ...: Lessons from 1890 Russian/Asiatic flu, 2020, Rosen

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https://journals.sagepub.com/doi/full/10.1177/0333102420965132

Keywords New daily persistent
headache, viral pandemic, Russian flu, SARS-CoV-2, neurasthenia, headache

 

Reference

Obviously the citation is misleading, as 12 patients with no controls can't define the majority of ndph sufferers, probably over-reps women and will all have come through the same clinic (rozen). But, I wil have to find a sci-hub to read this full paper. I was aware of a vague link of hEDS to NDPH, though obviously much weaker than what is suggested here, not the cci reference.

 

Rozen summarizes more of his ideas here. https://sci-hub.se/https://doi.org/10.1111/head.13624 (2019 publication)

The suggestion is that in some cases there is "cervicogenic irritation" due to cervical hypermobility in some subset. However, he does not reference fusion surgery as a treatment.

Interestingly, he frequently references intubation surgeries as a cause of some ndph, which reminded of Brea's thyroid surgery and development of CCI symptoms.

Other subsets are thought to include post-viral that does not respond to treatment as well as increased/decreased CSF or cerebral hypovlemia which can be treated accordingly.

Not that most neurologist still treat ndph as the headache type it most resembles (migraine/tension) and use the drugs accordingly, with a generally low success rate.

Rozen does claim here that

but his reference is the same 2006 study.

 

I've had a diagnosis of NDPH from a number of years ago, as I developed a new-onset headache with the infection that led to my developing ME, and the headaches were serious enough for me to request a neurology referral. After an MRI to exclude secondary headache and after trying a number of standard migraine treatments, I was referred to one of the UK's few headache centres where that diagnosis was replaced by one of NDPH.

Interestingly, the headache-specialist neurologist I've seen - before I became housebound - has told me on more than one occasion that he suspects an overlap between NDPH and "CFS". Apparently, he has a number of patients with a history of novel headache of post-infectious onset with both ME/CFS and NDPH diagnoses being made. Perhaps this is just a curio of referral bias - an artifact of unusual cases being referred to tertiary-care clinics - or perhaps there is something more to it.

It seems that NDPH is not usually diagnosed outside specialist headache clinics, ordinarily being attributed by GPs or general neurologists to chronic migraine or (if mild and lacking in migrainous features) chronic tension-type headache.

For me, headache is merely one of the many - and definitely not the most serious - symptoms of ME, and I've always associated headaches more with the PEM state. I was surprised by the seriousness with which the NDPH diagnosis was treated in the clinic I attended.

As far as I know, the location, character, nature and duration of headaches in ME - although anecdotally severe headaches are very common for us - is not particularly well-surveyed save for this Ravindran et al. paper. NDPH is not mentioned in that paper, but it is from 2011, and the previous ICHD-2 criteria for NDPH (that were in use prior to 2013) were far more restrictive and excluded patients with headaches that had migrainous features.

I'd be interested to know how many ME and long-COVID patients have developed headaches that meet the current ICHD-3 criteria for NDPH.

 

It's not clear to me whether by "neurologic sequelae that presented months to years after the pandemic ended" they mean "continued to present" or "first presented" - months to years after the pandemic ended.

I developed really severe daily persistent headaches beginning only several months after the infection that led to the onset of ME/CFS. It was part of the continuing decline during the first six months after onset. It's hard to describe how relentless and intense these headaches were. They seemed to shrug off any pain relievers that I threw at them. It was probably the most torturous period of the initial decline. It lasted about two months and then it just let up and stopped as mysteriously as it had begun.

I don't have any hypermobility issues so far as I know, although I can lock my thumb joints (but not my finger joints) as in this admittedly disturbing image.


https://en.wikipedia.org/wiki/Hypermobility_(joints)

 

No offense intended. People have had surprisingly strong reactions just from seeing me lock my thumb, so I thought I'd provide a sort of forewarning.