Headache is an uncommon feature of Guillain-Barre syndrome (GBS), which is more frequently associated with severe limb and/or back pain. However, when it does it occur, headache in GBS may emanate from a range of causes, including raised intracranial pressure, reversible cerebral vasoconstriction syndrome, posterior reversible encephalopathy syndrome, or due to complications of intravenous immunoglobulin (IVIg) therapy, such as aseptic meningitis and cerebral venous sinus thrombosis. Hypnic headache (HH)like phenomenon has not been thus far described in association with GBS. We report herein a patient with GBS who developed HH-like phenomenon during the recovery phase; she developed a cyclical nocturnal headache lasting around four hours and demonstrated exquisite response to caffeine. We postulate potential mechanisms for the same.
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