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The aim of this study was to investigate the diagnostic value of pericranial muscle tenderness (PT) and neck mobility assessment in differentiating primary from secondary headache in patients with acute headache, when life-threatening conditions like subarachnoid haemorrhage (SAH) and meningitis have been ruled out. Two neurologists made diagnoses independently, placing patients in either a primary or a secondary headache group. Patients without SAH or meningitis were examined for PT and neck mobility by a single examiner. Headache-free patients acted as controls. We found no significant difference in PT between primary and secondary headache patients, or between secondary headache patients and controls. There were no significant differences in neck mobility between any groups. Our findings suggest that assessment of PT and neck mobility does not help to distinguish acute primary from secondary headaches when SAH and meningitis have been excluded.

Background: Patients with episodes of headache associated with transient neurologic deficits and lymphocytes in the cerebrospinal fluid have been reported over the last two decades., Material and Methods: We present five patients without a prior history of migraine who experienced a limited series of 1-10 episodes of headache associated with transient neurologic deficits and lymphocytosis ranging from 85 to 500 x 10(6)/l in the cerebrospinal fluid., Results: Some patients had elevated protein levels in the cerebrospinal fluid and focal EEG pathology. Analysis of cerebrospinal fluid, blood tests and imagining investigations did not give plausible aetiological explanations., Interpretation: The prognosis of this syndrome is good. Its aetiology is unknown. It is reasonable to search for neurotropic viruses in future cases.