Benign Hot Bath‐Related Headache

Abstract

We describe three cases of women with hot bath-related headache who reported that their severe paroxysmal headache could be provoked by pouring hot water over themselves or by soaking in a hot bath. In one patient, the headache was also brought on by exposure to cold wind. Another patient had headaches after she dived into a pool and started swimming. Neurological examination, routine laboratory tests, electroencephalography, and brain imaging showed no abnormality in any of the patients. Hot bath-related headache is a benign headache unassociated with a structural lesion.Key words: hot bath, headache, cold stimulus headache ( Headache 2000;40:173-175) We describe three cases of women with hot bathrelated headache who reported that their severe paroxysmal headaches were provoked by pouring hot water over themselves or by soaking in a hot bath. CASE HISTORIESPatient 1.-A 54-year-old woman developed a paroxysmal splitting headache with floating sensation in the bathroom for the first time on April 22, 1992. The headache lasted 5 to 10 minutes. She had suffered from tension-type headaches previously. The next day, she had the same severe headache with floating sensation when she undressed and poured hot water over herself just before soaking in a hot bath. The headache was not throbbing and lasted 10 minutes without photophobia, phonophobia, nausea, vomiting, and vertigo. Whenever she tried to take a hot bath daily for a week, this headache was brought on after pouring hot water over herself, but before soaking in the hot bath. She could not take a hot bath for 10 days because of this headache. On two occasions, she took a tablet containing ergotamine tartate, 1 mg, caffeine, 50 mg, and isopropylantipyrine, 300 mg, 30 minutes before she had a hot bath, however, she still had severe headaches. When she washed only her hair without undressing, she did not have a headache. The results of her neurological examination were normal. She was normotensive. The findings of a routine blood examination, a CT scan of the brain, MRI and angiography (MRA) of the brain, electroencephalography, and an HM-PAO SPECT scan of the brain were all negative. By avoiding taking a hot bath, she did not experience this severe headache at all. One month later, when she tried to pour hot water over herself in a hot bath, she did not develop a headache. Since that time, she has not experienced this severe headache.Patient 2.-A 49-year-old woman developed a severe bursting headache in the right occipital area for a few seconds when she went out of the house into the cold on the evening of January 22, 1991. The next day, she poured hot water over herself before taking a bath and developed a severe bursting headache in the right frontal to occipital area. She took an analgesic and diazepam, 5 mg. Her headache lasted 3 hours. Within a week, she had the headache whenever she poured hot water over herself before soaking in a hot bath. Twice she soaked in the hot bath despite the headache, but on other occasions she could not bathe and took an analg...

Bath-Related Headache-The Second Case in South America

“…Bath-related headache (BRH) is a rare headache disorder first described by Negoro et al [1] and since its initial description, few cases have been described. Therefore, there are no established diagnostic criteria for this unusual form of headache.…”

“…In recent years, some descriptions of a new headache have appeared in which the warm stimulus applied on the head was the one provoking the headache. The onset of this headache is more frequent when the patient wets the head with hot water [4,[6][7][8][9]11], but this headache disorder may be triggered by the patient pouring hot water over his/her body [1,5,6] or soaking in hot water [1,10].…”

“…Bath-related headache (BRH) is a rare headache disorder described initially by Negoro et al [1]. It is characterized by developing while the patient is bathing in hot water or immersion in a hot bath.…”

“…To date, most cases reported (22/24; 91.7%) in the literature have occurred in the Asian population of five countries: China (8 cases) [3,4], Japan (4 cases) [1,5], Taiwan (5 cases) [6,7], Turkey (4 cases) [8] and Korea (1 case) [9]. There is only one case in Europe (Spain) [10] and another in South America (Brazil) [11].…”

Bath-related headache: a Brazilian case report

“…The first reference in the literature is of three middle-aged Japanese patients who, in 1992, developed symptoms of abrupt headache onset, of explosive and violent characteristic, caused by drop of hot water over the body in the shower which persisted for several weeks and resolved 1 . All the cases reported in the literature occurred in Asian populations 1,2 , and there is a unique report on a Spanish woman 3 . We present a case of a Brazilian patient with no Asian ancestry.…”