Home Introduction Prefaces Introduction to the classification How to Use This Classification Subcommittees and working groups The Classification Table of contents Part I: The primary headaches Part II: The secondary headaches Part III: Cranial neuralgias, facial pain and other headaches Appendix Definition of Terms

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A1. MigraineA2. Tension-type headacheA3. Cluster headache and other trigeminal autonomic cephalalgiasA6. Headache attributed to cranial or cervical vascular disorderA7. Headache attributed to non-vascular intracranial disorderA8. Headache attributed to a substance or its withdrawalA9. Headache attributed to infectionA9.1. Headache attributed to intracranial infection [G00-G09]A9.1.6. Headache attributed to space-occupying intracranial infectious lesion or infestationA9.1.7. Headache attributed to intracranial parasitic infestationA9.4. Chronic post-infection headache [code to specify aetiology]BibliographyA10. Headache attributed to disorder of homoeostasisA11. Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cranial structuresA12. Headache attributed to psychiatric disorderA13. Cranial neuralgias and central causes of facial pain

IHS	Diagnosis	ICD-10
A9.1.7	Headache attributed to intracranial parasitic infestation
Coded elsewhere	Headache attributed to space occupation by rather than to a direct effect of an intracranial parasitic infestation is coded as A9.1.6 Headache attributed to space-occupying intracranial infectious lesion or infestation.

Comment:

Parasitic infestations are characterised by an acute stage and a chronic stage. Headache in the acute stage is usually due to meningitis while headache in the chronic stage is believed to be due to encephalitic changes or secondary to neuropsychological deterioration. Systematic studies of the headaches caused by these disorders are lacking and therefore diagnostic criteria can only be proposed with great uncertainty.

Diagnostic criteria:

Headache with one or other of the following characteristics, with or without focal neurological symptoms and/or signs and fulfilling criteria C and D:
1. headache, with acute onset, resembling 9.1.1 Headache attributed to bacterial meningitis
2. headache with more insidious onset and characteristic of chronic meningoencephalitis
Evidence of an intracranial parasitic infestation from CSF examination, blood serology and/or neuroimaging
Headache develops during the parasitic infestation
Headache resolves within 3 months after successful treatment of the infestation

Comments:

Headache is a common and frequently the first symptom of intracranial parasitic infestation. A wide variety of parasitic organisms may infest the central nervous system, directly or indirectly. Whereas Trypanosoma cruzi (American trypanosomiasis, Chagas' disease) may cause acute meningitis, T. brucei gambiense (West African trypanosomiasis, Gambian sleeping sickness) and T. brucei rhodesiense (East African trypanosomiasis, East African sleeping sickness) cause a chronic meningoencephalitis.

Predisposing factors include exposure to parasites in tropical and/or subtropical areas of prevalence and, in a few instances, immunocompromised status.

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IHS vs. ICD-10

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