Chronic daily headache

Abstract

Headache is a relatively neglected neurological disorder. Indeed, many neurologists find outpatient headache management—particularly of chronic daily headache—one of the least engaging parts of their job. The neglect of headache as a research problem has been reversed by the relatively recent emergence of strong programmes in centres such as Copenhagen, London, Philadelphia, New York, Liege and Leiden. Partly as a result of this, the pejorative attitude to headache as a clinical problem is less than it was, but many neurologists are still bemused by the intrusion of headache, both at a local level when headache patients occupy scarce specialist beds, and at a global level where the World Health Organization ranks migraine in the top 20 causes of global disability. This article reviews one of the commonest headache syndromes encountered by neurologists—chronic daily headache.