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Hypnic headache

Field	Value
name	Hypnic headache
field	Neurology
duration	2 days - 1 week
frequency	20%
deaths	3K

Hypnic headaches are benign primary headaches that affect the elderly, with an average age of onset at 63 ± 11 years. They typically begin a few hours after sleep begins and can last from 15–180 min. There is normally no nausea, photophobia, phonophobia or autonomic symptoms associated with the headache. They commonly occur at the same time every night possibly linking the headaches with circadian rhythm, but polysomnography has recently revealed that the onset of hypnic headaches may be associated with REM sleep.

Diagnosis

For diagnosis of hypnic headache syndrome, headaches should occur at least 15 times per month for at least one month. Included in the differential diagnosis of a new onset nighttime headaches in the elderly is drug withdrawal, temporal arteritis, Sleep apnea, oxygen desaturation, pheochromocytoma, intracranial causes, primary and secondary neoplasms, communicating hydrocephalus, subdural hematoma, vascular lesions, migraines, cluster headaches, chronic paroxysmal hemicrania, headaches due to bruxism, and hypnic headache. All other causes must be ruled out before the diagnosis of hypnic headache can be made.

Treatments

Lithium carbonate 200–600 mg at bedtime is an effective treatment for most patients but for those that can not tolerate lithium, Verapamil, indomethacin, melatonin or methysergide may be tried. Two patients have also responded to flunarizine 5 mg. It has also been shown that 1–2 cups of coffee or 100–200 mg of caffeine before bed can prevent hypnic headaches.

A recent review of 348 cases available in the literature has been recently published.

References

(December 1997). "Unilateral hypnic headache: a case study". Neurology.
Goadsby, Peter J.. (2002). "Headache in clinical practice". Martin Dunitz.
(March 2003). "Hypnic headache: clinical features, pathophysiology, and treatment". Neurology.
(2015). "Headache secondary to sleep-related bruxism: A case with polysomnographic findings". Journal of Neurosciences in Rural Practice.
(2005). "Review: Hypnic headache". Practical Neurology. Review.
(June 2019). "Hypnic headache: A review of 348 cases published from 1988 to 2018". Journal of the Neurological Sciences.

Wikipedia Source

This article was imported from Wikipedia and is available under the Creative Commons Attribution-ShareAlike 4.0 License. Content has been adapted to SurfDoc format. Original contributors can be found on the article history page.

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