NDPH.org

Is this NDPH? A checklist to take to your doctor.

New Daily Persistent Headache is diagnosed by excluding other causes — which needs an examination, and usually a scan. No questionnaire can do that, and this one does not try.

What it does instead: check your pattern against the published ICHD-3 criteria, flag the features that point away from NDPH and toward something that needs looking into, and give you a summary to bring to an appointment. Ten minutes of a consultation is not long, and arriving with your history already organised changes what you get out of it.

Everything stays in your browser. Nothing is sent anywhere, nothing is stored, and no one — including us — sees your answers.

1. First, the things that can't wait

Tick anything you are experiencing now or that came on suddenly.

A headache that hit maximum intensity within about a minute — the worst of your life Fever with a stiff neck, or a rash New weakness, numbness, trouble speaking, or loss of vision A seizure Confusion, or difficulty staying awake A headache that began after a blow to the head

2. Features that point somewhere else

These don't rule NDPH out, but each one has a specific cause behind it that a doctor would want to exclude first.

The pain is clearly worse when I am upright and eases when I lie flat The pattern of a spinal fluid leak. It is worse lying down, on waking, or when I cough, strain or bend over Can indicate raised pressure inside the head. Brief greying or blurring of vision, or a whooshing sound in time with my pulse Also associated with raised pressure. It started after I turned 50 Tenderness of the scalp or temples, or jaw ache when chewing Fever, night sweats, or unexplained weight loss A history of cancer, or a weakened immune system I am pregnant, or gave birth in the last few months It has been steadily worsening rather than staying constant

3. The ICHD-3 pattern

These four are what the published criteria for NDPH actually ask.

Can you name the day, or close to it, that the headache began? Yes No

Did it become continuous within 24 hours of starting? Yes No

Has it been there every day for more than 3 months? Yes No

Has it been unremitting — never fully going away, even briefly? Yes No

4. Two things that change the answer

Both of these outrank NDPH in the classification, so they matter more than they look.

Do you take painkillers, triptans or similar on 10 or more days a month (15 or more for plain paracetamol, aspirin or ibuprofen)? Yes No

If yes — did the daily headache clearly begin before you started taking them that often? Yes No N/A

Is the pain always on the same one side, never switching, with a watering or red eye, blocked nostril or drooping lid on that side? Yes No

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