title: Headache as a first manifestation of Vogt-Koyanagi-Harada disease.
abstract: OBJECTIVE
  To describe headache as an initial presentation of Vogt-Koyanagi-Harada (VKH) disease.
  
  
  METHODS
  A 56-year-old man initially presented with a 6-month duration of a continuous, diffuse headache of mild to moderate and sometimes of severe intensity. A CT of the brain was normal. Neurological examination was normal, including absence of symptoms and signs of meningismus. During the last 2 months, an intermittent eye pain, redness, and gradual loss of vision in both eyes was detected and subsequently he had tinnitus, malaise, nausea and mild meningismus. He was diagnosed as having VKH disease. Ophthalmologic examination revealed high intraocular pressure, requiring trabeculectomy with surgical iridectomy. The patient is now being treated with systemic steroids.
  
  
  CONCLUSIONS
  VKH disease may initially present as sustained headache, without specific ophthalmologic symptoms and it should be considered in the differential diagnosis in patients with atypical but relentless headache.
authors.affiliation: Department of Neurology, University of Athens, Aeginition Hospital, Athens, Greece.
authors.forename: Katerina K
authors.initials: KK
authors.lastname: Kosma
authors.forename: Evangelia
authors.initials: E
authors.lastname: Kararizou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Markou
authors.forename: Evanthia
authors.initials: E
authors.lastname: Eforakopoulou
authors.forename: Grigoris
authors.initials: G
authors.lastname: Kararizos
authors.forename: Charalampos
authors.initials: C
authors.lastname: Mitsonis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Gkiatas
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000477:Alkylating Agents / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D006261:Headache / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014607:Uveomeningoencephalitic Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000305:Adrenal Cortex Hormones; D000477:Alkylating Agents; D016572:Cyclosporine