7.3.2 Headache attributed to aseptic (non-infectious) meningitis

Description:

Headache caused by aseptic meningitis, associated with other symptoms and/or clinical signs of meningeal irritation. It resolves after resolution of the meningitis.

Diagnostic criteria:
  1. Any headache fulfilling criterion C
  2. Aseptic meningitis has been diagnosed by cerebrospinal fluid (CSF) examination1
  3. Evidence of causation demonstrated by at least two of the following:
    1. headache has developed in temporal relation to the onset of the aseptic meningitis, or led to its discovery
    2. either or both of the following:
      • a) headache has significantly worsened in parallel with worsening of the aseptic meningitis
      • b) headache has significantly improved in parallel with improvement in the aseptic meningitis
    3. headache is accompanied by other symptoms and/or clinical signs of meningeal inflammation including neck stiffness (meningismus) and/or photophobia
  4. Not better accounted for by another ICHD-3 diagnosis.
Note:

The CSF in patients with aseptic meningitis shows lymphocytic pleocytosis, mildly elevated protein and normal glucose in the absence of infectious organisms.

Comment:

Aseptic meningitis may occur after exposure to certain drugs, including ibuprofen or other NSAIDS, immunoglobulins, penicillin or trimethoprim, intrathecal injections and/or insufflations.