Abstract
Medication overuse headache (MOH), new daily persistent headache (NDPH), and persistent
refractory headache attributed to severe acute respiratory syndrome coronavirus 2
(SARS-CoV2) infection represent a significant burden in terms of disability and quality
of life, and a challenge in terms of definition, pathophysiology, and treatment. Regarding
MOH, prevention without withdrawal is not inferior to prevention with withdrawal.
Preventive medications like topiramate, onabotulinumtoxinA, and calcitonin gene-related
peptide (CGRP) monoclonal antibodies improve chronic migraine with MOH regardless
of withdrawal. The differential diagnosis of NDPH is broad and should be carefully
examined. There are no guidelines for the treatment of NDPH, but options include a
short course of steroids, nerve blocks, topiramate, nortriptyline, gabapentin, CGRP
monoclonal antibodies, and onabotulinumtoxinA. The persistence of headache 3 months
after SARS-CoV2 infection is a predictor of poor prognosis.
Keywords
new daily persistent headache - medication overuse headache - medication adaptation
headache - chronic refractory headache attributed to SARS-CoV2 infection