Exploding Head Syndrome Research Articles

Unusual Headache Disorders.

Unusual headache disorders are less commonly discussed and may be misdiagnosed. These headache disorders frequently have a benign natural history; however, without reassurance, therapeutic education, and treatment, they can negatively affect the health and function of patients. This article reviews the clinical features, diagnosis, workup, and proposed treatments for several unusual headache disorders including primary cough headache, primary headache associated with sexual activity, primary exercise headache, cold-stimulus headache, primary stabbing headache, nummular headache, hypnic headache, and headache attributed to travel in space. Exploding head syndrome is also discussed, which is a sleep disorder commonly confused with a headache disorder. Unusual headache disorders are usually benign, yet without the correct diagnosis can be very worrisome for many patients. Through greater awareness of these headache disorders, neurologists can evaluate and effectively manage unusual headache disorders, which offers significant benefits to patients and practice satisfaction to neurologists.

Exploding Head Syndrome: a Review.

To explain our current understanding of exploding head syndrome (EHS), an unusual and underreported sensory parasomnia. Based on findings from recent studies of EHS, the prevalence is higher than previously suggested by the literature, which historically has consisted mostly of case reports. The typical presentation also has been better illustrated by recent case series, and diagnostic criteria have been defined. Its pathophysiology is still unclear. EHS is underrecognized and its symptoms are alarming, but a review of our current state of knowledge will allow physicians to make a diagnosis of this benign condition with greater confidence.

Therapeutic Symptomatic Strategies in the Parasomnias.

The purpose of this review was to discuss the currently available pharmacologic and non-pharmacologic treatment options for parasomnias. Recent pathophysiological findings about sleep structure in parasomnias helped understanding several drug mechanisms of action. Serotoninergic theory accounts for the effect of serotoninergic drugs. Study about spectral analysis of sleep showed the effect of clonazepam on spectral bands. Cannabinoids proved to be effective in some of parasomnias, as in many other neurological disorders. A series of therapeutic strategies were analyzed and compared. Benzodiazepines, antidepressant drugs, and L-5-hydroxytryptophan may be beneficial in DOA. SSRI and topiramate are effective in SRED. RBD responds to clonazepam, melatonin, and to a lesser extent to dopaminergic and anticholinergic agents. Prazosin and cannabinoids are effective in nightmare disorder. Sleep paralysis may respond to antidepressant agents. Tricyclic antidepressant may be effective in sleep-related hallucinations and exploding head syndrome. Sleep enuresis may be successfully treated with desmopressin, anticholinergic drugs, and imipramine.

Did René Descartes Have Exploding Head Syndrome?

René Descartes (1596-1650), "the Father of Modern Philosophy" and advocate of mind-body dualism, had three successive dreams on November 10, 1619 that changed the trajectory of his life and the trajectory of human thought. Descartes' influential dreams have been of interest to a number of commentators including the famous neurologist and psychoanalyst Sigmund Freud. Descartes' second dream in particular, in which he heard a loud noise in his head before seeing a bright flash of light upon awakening, has been discussed extensively. Commentators have employed psychoanalytic and medical explanations to account for Descartes' unusual nocturnal experience. In this tradition, I propose that Descartes' second dream was not a dream at all; rather, it was an episode of exploding head syndrome; a benign and relatively common parasomnia. I further suggest that Adrien Baillet's account of Descartes' experience constitutes the earliest description of exploding head syndrome, predating the account described by Silas Weir Mitchell in 1876 by nearly 200 years.

Exploding head syndrome: a co-activation of alpha-frequency band oscillations as a novel interictal fingerprint?

Exploding head syndrome: a co-activation of alpha-frequency band oscillations as a novel interictal fingerprint?

0736 POLYSOMNOGRAHIC FINDINGS IN FIVE PATIENTS WITH EXPLODING HEAD SYNDROME

Exploding Head Syndrome (EHS) attacks are characterized by perception of sudden loud banging noises, occasionally accompanied by the sensation of a flash of light. Although these attacks themselves are usually not painful, it is reported that EHS attacks may precede migraine as auras. EHS is classified as a type of parasomnia in the International Classification of Sleep Disorders (ICSD) 3rd edition and its pathophysiology is still unclear. We describe the polysomnography (PSG) characteristics of EHS patients with special emphasis on respiratory events that were followed by EHS attacks. The subjects were consecutive 20,926 patients who presented sleep and/or wake problems at our sleep center between April 1998 and March 2013. The diagnosis of EHS was based on ICSD-3 criteria. During PSG, we instructed them to ring a bell when they noticed an attack (heard a sound). We found 5 cases (0.17%) with EHS. The mean age (2 men and 3 women) was 64.8 ± 16.4 years. Three of them had otorhinolaryngologic diseases (sudden hearing loss, deflected nasal septum and sinusitis). All five subjects rang the bell for their attacks during PSG. The events occurred during stage N1 and N2. In 2 cases, respiratory events preceded the attacks. In 1 case, respiratory effort related arousal was followed by the attack. In the other 2 cases snoring preceded the attacks. One subject noticed the attack during stage W. Various respiratory events were related to the EHS attacks. A variety of ear dysfunctions or brainstem neural dysfunction during the transition from wakefulness to sleep has been reported as the pathophysiology of EHS. Our PSG findings suggest that checking otolaryngological status on subjects and respiratory events during sleep may be helpful in understanding its pathophysiology and in choosing therapeutic strategies. None.

Characteristic symptoms and associated features of exploding head syndrome in undergraduates.

Background Exploding head syndrome (EHS) is characterized by loud noises or a sense of explosion in the head during sleep transitions. Though relatively common, little is known about its characteristic symptoms or associated features. Methods A cross-sectional study of 49 undergraduates with EHS was performed. A clinical interview established diagnosis. Results The most common accompanying symptoms were tachycardia, fear, and muscle jerks/twitches with the most severe associated with respiration difficulties. Visual phenomena were more common than expected (27%). EHS episodes were perceived as having a random course, but were most likely to occur during wake-sleep transitions and when sleeping in a supine position. Only 11% reported EHS to a professional, and 8% of those with recurrent EHS attempted to prevent episodes. Conclusions EHS episodes are complex (Mean (M) = 4.5 additional symptoms), often multisensorial, and usually associated with clinically-significant fear. They are rarely reported to professionals and treatment approaches are limited.

Exploding Head Syndrome in the Epilepsy Monitoring Unit: Case Report and Literature Review

Diagnosis of paroxysmal events in epilepsy patients is often made through video-telemetry electroencephalography in the epilepsy monitoring unit. This case report describes the first-ever diagnosis of exploding head syndrome in a patient with longstanding epilepsy and novel nocturnal events. In this report, we describe the presentation of exploding head syndrome and its prevalence and risk factors. In addition, the prevalence of newly diagnosed sleep disorders through video-telemetry electroencephalography in the epilepsy monitoring unit is briefly reviewed. This report also illustrates the novel use of clobazam for the treatment of exploding head syndrome.

Primary headache syndromes in the elderly: epidemiology, diagnosis and treatment

Although secondary headaches due to e.g. temporal arteritis or a brain tumor are common among the elderly, primary headache disorders also occur in this age group, albeit less frequently than in younger individuals. A different presentation in the older age groups often makes a diagnosis difficult. Some headache syndromes, such as hypnic headache, are typical for the elderly. Furthermore, age-related physiologic changes, co-morbidities and contra indications require appropriate and targeted treatment in the elderly. Although treatments for the most common primary headaches are available, many limitations hamper their use in this group. For many headaches syndromes randomized controlled treatment trials in elderly are not available. In this article we review the clinical aspects of common primary headaches and medication overuse headache in the elderly and their treatments, with emphasis on age-specific problems. Relevance for patients: Primary headache syndromes in older patients ask for specific treatment considerations due to comorbidity, polypharmacy and an increased risk of side effects. Clinically, the headaches can be different and atypical. Results from clinical trials cannot be generalized to the elderly because these groups usually are not included in studies. In migraine, non-pharmacologic treatment should be considered, with depression and cerebrovascular disease as major comorbidities. Tension type headache, being the most common headache presentation in elderly, also includes a relatively large proportion of patients with a secondary headache warranting further testing. Trigeminal autonomous cephalalgias are rare, and can present with pseudo dementia. Medication overuse and medication-induced headaches are relatively common, for which patient education, ceasing drugs and withdrawal from caffeine containing substances are pivotal. Furthermore, hypnic headache, exploding head syndrome and benign thunderclap headache are specific for this patient group and require specific treatment.

Unique Migraine Subtypes, Rare Headache Disorders, and Other Disturbances.

The medical aphorism that common things happen commonly makes unique (and less common) migraine subtypes especially appropriate to review for the general neurologist. This article also identifies some rare headache disorders and other disturbances, and offers strategies to manage them. This article discusses migraine with brainstem aura, which is troublesome clinically and has had a change in terminology in the International Classification of Headache Disorders, Third Edition, beta version (ICHD-3 beta), and hemiplegic migraine, which is also troublesome in practice. The rare headache disorder hypnic headache and the exploding head syndrome are also discussed. When hypnic headache is recognized, it is eminently treatable, while exploding head syndrome is a benign condition with no reported consequences. Unique migraine subtypes, rare headache disorders, and other disturbances present to neurologists. When recognized, they can often be managed very well, which offers significant benefits to patients and practice satisfaction to neurologists.

Exploding head syndrome is common in college students.

Exploding head syndrome is characterized by the perception of loud noises during sleep-wake or wake-sleep transitions. Although episodes by themselves are relatively harmless, it is a frightening phenomenon that may result in clinical consequences. At present there are little systematic data on exploding head syndrome, and prevalence rates are unknown. It has been hypothesized to be rare and to occur primarily in older (i.e. 50+years) individuals, females, and those suffering from isolated sleep paralysis. In order to test these hypotheses, 211 undergraduate students were assessed for both exploding head syndrome and isolated sleep paralysis using semi-structured diagnostic interviews: 18.00% of the sample experienced lifetime exploding head syndrome, this reduced to 16.60% for recurrent cases. Though not more common in females, it was found in 36.89% of those diagnosed with isolated sleep paralysis. Exploding head syndrome episodes were accompanied by clinically significant levels of fear, and a minority (2.80%) experienced it to such a degree that it was associated with clinically significant distress and/or impairment. Contrary to some earlier theorizing, exploding head syndrome was found to be a relatively common experience in younger individuals. Given the potential clinical impacts, it is recommended that it be assessed more regularly in research and clinical settings.

Chapter 24 - Auditory hallucinations

Auditory hallucinations constitute a phenomenologically rich group of endogenously mediated percepts which are associated with psychiatric, neurologic, otologic, and other medical conditions, but which are also experienced by 10-15% of all healthy individuals in the general population. The group of phenomena is probably best known for its verbal auditory subtype, but it also includes musical hallucinations, echo of reading, exploding-head syndrome, and many other types. The subgroup of verbal auditory hallucinations has been studied extensively with the aid of neuroimaging techniques, and from those studies emerges an outline of a functional as well as a structural network of widely distributed brain areas involved in their mediation. The present chapter provides an overview of the various types of auditory hallucination described in the literature, summarizes our current knowledge of the auditory networks involved in their mediation, and draws on ideas from the philosophy of science and network science to reconceptualize the auditory hallucinatory experience, and point out directions for future research into its neurobiologic substrates. In addition, it provides an overview of known associations with various clinical conditions and of the existing evidence for pharmacologic and non-pharmacologic treatments.

Exploding head syndrome – a rare parasomnia or a dissociative episode?

Exploding head syndrome – a rare parasomnia or a dissociative episode?

Unusual Headache Syndromes

Some headache syndromes have few cases reported in the literature. Their clinical characteristics, pathogenesis, and treatment may have not been completely defined. They may not actually be uncommon but rather under-recognized and/or underreported. A literature review of unusual headache syndromes, searching PubMed and ISI Web of Knowledge, was performed. After deciding which disorders to study, relevant publications in scientific journals, including original articles, reviews, meeting abstracts, and letters or correspondences to the editors were searched. This paper reviewed the clinical characteristics, the pathogenesis, the diagnosis, and the treatment of five interesting and unusual headache syndromes: exploding head syndrome, red ear syndrome, neck-tongue syndrome, nummular headache, and cardiac cephalgia. Recognizing some unusual headaches, either primary or secondary, may be a challenge for many non-headache specialist physicians. It is important to study them because the correct diagnosis may result in specific treatments that may improve the quality of life of these patients, and this can even be life saving.

A Case of Sick Sinus Syndrome Presenting as Exploding Head Syndrome

A Case of Sick Sinus Syndrome Presenting as Exploding Head Syndrome

A Case of Exploding Head Syndrome

Received March 27, 2012 Revised May 30, 2012 Accepted May 30, 2012 Address for correspondence Sang-Ahm Lee, MD, PhD Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea Tel: +82-2-3010-3445 Fax: +82-2-474-4691 E-mail: salee@amc.seoul.kr Exploding head syndrome (EHS) is a rare phenomenon of unknown etiology, characterized by a sense of an explosive noise in the head usually in the wake-sleep transition. The sufferers experience a loud bang in their head that seems to originate from inside the head. We describe a 55-year old male with symptoms of a loud bang, spark and electrical current running like noise at sleep onset for one year. On video-electroencephalography monitoring, the events occurred during sleep-wake transition. We diagnosed him to EHS based on typical clinical features. J Korean Sleep Res Soc 2012;9:19-21

A Case of Exploding Head Syndrome: Focus on Polysomnographic Finding

Received December 14, 2011 Revised December 24, 2011 Accepted December 26, 2011 Address for correspondence Won Chul Shin, MD Department of Neurology, College of Medicine, Kyung Hee University, 892 Dongnam-ro, Gangdong-gu, Seoul 134-727, Korea Tel: +82-2-440-6166 Fax: +82-2-440-7243 E-mail: shinwc@khu.ac.kr Exploding head syndrome is a rare nocturnal disorder that the patient experiences a loud sound. The events occur usually during a period of drowsiness preceding sleep. The polysomnography studies in exploding head syndrome are very rare. We report a case of exploding head syndrome that a total of 8 typical episodes were recorded in polysomnography. A 51 years old female was admitted due to nocturnal loud sound from 2 month ago. There was no headache and no history of sleep problems. During the polysomnography, the events recorded 8 times, 6 of the events occurred during waking time prior to sleep onset, 2 developed in N1 sleep. In our case, the events appear to arise from early drowsiness with predominant alpha rhythm, with interspersed theta activity. J Korean Sleep Res Soc 2011;8:45-47

Exploding head syndrome – the early steps

Exploding head syndrome is a rare entity associated with migraine that occurs during sleep onset. A male migraine with aura patient presented with episodes of abrupt awakening following perceptions of sounds resembling a speeding up motorcycle engine interspersed with bursts of exhaust explosions like noises, accompanied by an exploding sensation in the head. The patient presented in the evolution of self-limited period of headache chronicity. This syndrome has been associated with an atypical form of acoustic aura that often leads to migraine chronification.

Unusual Headaches in the Elderly

Prevalence of headache lowers with age, and headaches of elderly adults tend to be different than those of the younger population. Secondary headaches, such as headaches associated with vascular disease, head trauma, and neoplasm, are more common. Also, certain headache types tend to be geriatric disorders, such as primary cough headache, hypnic headache, typical aura without headache, exploding head syndrome, and giant cell arteritis. This review provides an overview of some of the major and unusual geriatric headaches, both primary and secondary.

Topiramate Responsive Exploding Head Syndrome

Exploding head syndrome is a rare phenomenon but can be a significant disruption to quality of life. We describe a 39-year-old female with symptoms of a loud bang and buzz at sleep onset for 3 years. EEG monitoring confirmed these events occurred in transition from stage 1 sleep. This patient reported improvement in intensity of events with topiramate medication. Based on these results, topiramate may be an alternative method to reduce the intensity of events in exploding head syndrome.