Abstract
Background: The frequent headache syndrome is among the most challenging disorder that conforms clinician on a routine basis. A major problem with the relatively new form chronic daily headache (CDH) has been its confusion with chronic tension type headache (CTTH) and other community used term for which there have never been operational diagnosable criteria or even informal clinical criteria. The medical literature is replete with example over the past three decades in which the terms mixed headache combined headache tension headache; vascular headache and rebound headache are used interchangeably by interference. CDH became synonymous in many clinical setting with CTTH or inconvenient vascular or migrainous features or medication overuse. Now CDH is well described in literature with defined classification. Hence, the researcher is used to interested what is the burden and proportion of the various type of CDH.

Aims and Objectives: Primary aim of this exploratory prospective study was to study the incidence of primary headache and secondary headache which were CDH in patient attending neurology outpatient department, to study the incidence of type of primary headache, the cause of secondary headache, the age wise distribution and sex wise attribution of CDH and to study the impact of family history, occupation and precipitating factor on CDH.

Materials and Methods: In our study, a total of 626 cases fulfilling the International Headache Society-4th revised criteria comprising inclusion and exclusion criteria were included after informed consent, meticulous history taking pertaining to headache, in particular, thorough examinations and relevant laboratory investigations, and were certified by one neurologist.

Results: Primary headache including migraine, tension-type headache, Short-lasting unilateral neuralgiform headache with conjunctival injection, new daily persistent headache, and medication overuse headache was the most common headache that caused CDH. Neurocysticercosis was leading cause of a secondary headache that leads to CDH. Light, fast, and stress were leading precipitants associated with CDH.

Conclusion: CDH was mostly associated with primary headache over the secondary headache. Chronic migraine was leading cause of CDH in comparison to CTTH. Females were more affected both in chronic migraine and CTTH. Family history was more positive in case of chronic migraine. Vomiting nausea, photophobia, and phonophobia vertigo were leading symptoms associated with CDH whereas light, fast, and stress were leading precipitants associated with CDH.

Key words: Primary Headache; Secondary Headache; Chronic Daily Headache; Chronic Tension Type Headache; Chronic Migraine; Neurocysticercosis