Chronic daily headache: A time perspective

Objective.-To determine the development and outcome of chronic daily headac he in 258 headache practice patients, consisting of 50 men and 208 women. C hronic daily headache was defined as headaches occurring on at least 5 days per week for at least 1 year. Methods.-Two hundred fifty-eight patients with headache were interviewed an d evaluated. Ninety-one patients were contacted by telephone for follow-up. Results.-Twenty-two percent of the patients had daily headaches from the on set, and 78% initially experienced intermittent headaches. Of the patients with initially intermittent headaches, 19% experienced an abrupt transition into daily headaches and 81%, a gradual one, In the patients with gradual transition, the transition of the initial, intermittent headaches into dail y headaches took an average of 10.7 years. The initial headaches were mild in 33% of the patients and severe in 67%, The severe headaches were associa ted with nausea and vomiting significantly more often than the mild ones. H owever, the daily headaches that these patients ultimately developed were t he same, regardless of whether the initial headaches were mild or severe. The patients who gradually developed daily headaches from initially intermi ttent headaches were contacted to determine the outcome of their headaches. Of these patients, 33% continued to have daily headaches and 67% again exp erienced intermittent headaches. Of the latter group, 88% of the patients w ho now had migraine also had migraine initially.