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7.3.2 Headache attributed to aseptic (non-infectious) meningitis


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.

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


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