Post-infectious headache: a reactive headache?

Abstract

Post-infectious disease syndrome includes both neurological and non-neurological disorders. However, headache as an isolated or a presenting complaint of post-infectious illness has not been well acknowledged in the literature. In this retrospective observation, patients having daily headache of more than 1 week and <4 weeks duration were included. We divided this group into patients having headache with preceding history of febrile illness in the recent past and patients without such history of febrile illness. We compared clinical features and therapeutic responses of various drugs between the groups. There were no significant differences in demographic features in these groups. However, associated neck pain, nausea, photophobia and meningeal signs were more prevalent in patients having history of preceding infection. A relatively lower proportion of subjects showed complete response to drugs at 3 months in post-infectious group. Good responses were noted to steroids in post-infectious group. In conclusion, a subset of patients with daily headache may be because of post-infectious pathology and treatment in the early stage may prevent it from becoming chronic. Large prospective studies are required to confirm these observations.

The Heterogeneity of New Daily Persistent Headache

“…Chronic post‐viral meningitis headache has not yet been proposed and is not a well‐reported entity . The appendix of the ICHD‐2 proposes an entity entitled “chronic post‐non‐bacterial infection headache.” Persistent headache after viral meningitis was described in a large series by Neufeld et al .…”

“…18 Chronic post-viral meningitis headache has not yet been proposed and is not a well-reported entity. 19 The appendix of the ICHD-2 proposes an entity entitled "chronic post-non-bacterial infection headache." Persistent headache after viral meningitis was described in a large series by Neufeld et al 20 In their study, 19 of 70 (27%) patients with meningitis developed post-meningitis headache, of whom 17 (89%) had aseptic/viral meningitis.…”

New Daily Persistent Headache: Disease or Syndrome?

“…In a retrospective study on patients with subacute daily headache (1-4 weeks durations), we observed that patients with a prior history of febrile illness are more likely to have neck pain and signs of meningismus (in addition to headache). 4 Our observation, 4 Almazov and Brand's observation, 2 and a few other observations 5 suggest a possibility of postinfectious pathology (most likely immunological) in meninges in patients who have a prior history of infections before the onset of headache. We further suggest that the interrelation between meninges and infections may be like the interrelation of synovial membrane to various viral infections for the development of reactive arthritis, as synovial membranes and meninges are of same type of tissue (membranous connective tissue).…”

Response Letter: New Daily Persistent Headache: Disease or Syndrome?

“…An inherent difficulty is that NDPH is only diagnosed after being present for at least 3 months, and capturing these patients in the subacute time frame may yield the most insights; so we applaud Dr. Prakash's contributions to this endeavor. 11 Matthew S. Robbins, MD, FAHS Montefiore Headache Center, Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA…”