New daily persistent headache (NDPH) is a rare primary headache with a sudden, precisely dated onset that is difficult to treat and can cause disability. The exact cause remains unknown. A case is reported of a patient with refractory NDPH who was treated with intravenous esketamine at a sub-anesthetic dose.
Periodic alpha-band brain activity, measured with electroencephalography (EEG) before treatment, predicts how well patients with episodic migraine without aura will respond to the preventive drug topiramate. Higher alpha power in specific brain regions—the cuneus, pericalcarine cortex, medial orbitofrontal cortex, frontal pole, and precuneus—indicates a poorer clinical response. A predictive model using these features achieved an area under the receiver operating characteristic curve of 0.859 in identifying treatment responders. The visual network and default mode network together explained 26.1% of the variance in headache improvement. These findings suggest that baseline alpha activity is a strong neurobiological marker for personalizing migraine preventive therapy.