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IHS Diagnosis ICD-10
9.1.3 Headache attributed to encephalitis [G04.9] G44.821  

Diagnostic criteria:

  1. Headache with at least one of the following characteristics and fulfilling criteria C and D:
    1. diffuse pain
    2. intensity increasing to severe
    3. associated with nausea, photophobia or phonophobia
  2. Neurological symptoms and signs of acute encephalitis, and diagnosis confirmed by EEG, CSF examination, neuroimaging and/or other laboratory investigations1
  3. Headache develops during encephalitis
  4. Headache resolves within 3 months after successful treatment or spontaneous remission of the infection

Notes:

  1. PCR method gives the specific diagnosis.

Comments:

The causes of headache include both meningeal irritation and increased intracranial pressure. Head pain may also be a systemic reaction to the toxic products of the infecting agent(s). Headache may occur early and be the only clinical symptom of encephalitis.

Herpes simplex virus, arbovirus and mumps are known causes of encephalitis. Except for HSV encephalitis (in which 95% of cases are identifiable with PCR), the causative virus is identified in fewer than half of cases of encephalitis.

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