Minor viral headache

Minor viral headaches are often seen in general practice. There is often little clue as to the viral origin of the headache except that a small cluster of similar cases have presented or that the GP has experienced similar symptoms.

Typically a minor viral headache:

• has a fairly rapid onset and no obvious explanation
• may or may not be associated with lethargy or malaise
• does not respond well to the usual minor analgesics
• is made worse by rapid head movements
• may be associated with aching eye muscles
• may occasionally be associated with mild photophobia
• lasts two to four weeks and then fades away
• shows no neurological signs with normal fundoscopy
• may be part of a respiratory or gastrointestinal infection or flu-like illness

Treatment is mostly reassurance. In severer forms, bed rest to keep the head still and Codeine or Dihydrocodeine may be prescribed. Diagnosis is based on clinical suspicion and on excluding the more sinister causes of headache mostly by good history-taking. The severest form is viral meningitis such as mumps meningitis and may need admitting.