Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Association between aseptic meningitis and jolt accentuation of headache in adults

Daisuke Kuzume, M.D.1), Yuko Morimoto, M.D.1), Masato Kinboshi, M.D., Ph.D1), Takeshi Yoshida, M.D.2) and Masahiro Yamasaki, M.D.1)

1)Department of Neurology, Chikamori Hospital
2)Department of Reumatology, Chikamori Hospital

Background and Purpose: The purpose of this study was to elucidate the association between aseptic meningitis and jolt accentuation of headache (JAH) in adults. Subjects and Method: 87 patients with meningeal irritation (age; 35.6 ± 13.3 years old, 45 males) who were admitted to our hospital from 1st August 2013 to 31st August 2018 were included. The diagnosis was determined according to the following criteria:, aseptic meningitis was defined as cerebrospinal fluids (CSF) pleocytosis with no evidence of bacterial infection, fungal infection or carcinomatous findings; meningism was defined as the absence of CSF pleocytosis. None of these patients had consciousness disturbance and focal neurological abnormalities. The blood and CSF data were reviewed for analysis. Results: 61 patients were in aseptic meningitis group, 26 patients were in meningism group. Multiple logistic regression analysis showed older age (OR 1.059, 95% Confidence interval (CI) 1.012-1.108, P = 0.013), lower CRP (OR 0.803, 95%CI 0.697-0.925, P = 0.002) and absence of JAH (OR 0.048, 95%CI 0.004-0.554, P = 0.015) were significantly associated with aseptic meningitis. The sensitivity and specificity of JAH in aseptic meningitis were 68.9%, 3.8%.
Full Text of this Article in Japanese PDF (272K)

(CLINICA NEUROL, 59: 596|599, 2019)
key words: jolt accentuation of headache, aseptic meningitis, meningeal irritation

(Received: 18-Feb-19)