To describe the characteristics of new daily persistent headache (NDPH) in the pediatric population.

NDPH diagnosis criteria as defined by the International Classification of Headache Disorders include persistent headache with: (1) distinct and clearly remembered onset, with pain becoming continuous and unremitting within 24 hours, (2) present for >3 months. It is one of the most treatment refractory of all primary headaches. At the present time, little is known of the disorder in children.

A retrospective chart review was conducted for a study population consisting of 348 patients seen in Columbia University Medical Center and Stamford Hospital. The charts of consecutive patients between the ages 5 to 21 diagnosed with NDPH between January 1, 2012 and December 31, 2017 were screened. Comparison of cases was made to age and sex matched controls with migraine in a ratio of 1:2. Demographic and general clinical characteristics were compared between groups. The risk factors and clinical features were examined by conditional logistic regression.

When evaluating NDPH against other populations we found NDPH was highest in females above 13 years of age. Most patients remembered the month of headache onset, but very few remembered the exact date. The frequency of onset peaked in February and December, with a post viral association linked during these months. The quality of the pain was more likely to be constant. Sleep issues were more common.

In univariate analyses, prior concussion, sinus issues and dizziness were associated with NDPH. None of the differences were statistically significant. In multivariable analyses, three variables were statistically significantly associated with NDPH. Fatigue (OR: 10.1{4.22-24.0}) was the most important clinical feature while nausea (OR: 0.36{0.17-0.75}) and vomiting (OR: 0.19 {0.07-0.50}) were less likely associated with NDPH.

The characteristic migrainous features were less noted while dizziness and fatigue were more prominent in NDPH patients.