Hypnic Headache Due to Hypoglycemia: A Case Report

Silva‐Néto, Raimundo Pereira; Soares, A.; Peres, Mário Fernando Prieto

doi:10.1111/head.13627

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…A huge variety of secondary causes for HH, such as brain tumors (29,30,32) or metabolic disorders have been reported (41). Those must be examined in all patients suffering from HH before diagnosing primary HH.…”

Section: Discussionmentioning

confidence: 99%

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Hypnic Headache – What do we know in 2022?

et al. 2023

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Background Hypnic Headache, also known as “alarm clock headache”, is a rare primary headache disorder. It is characterized by frequently recurring headache attacks, which only develop during sleep, especially nighttime sleep. Objective This article gives a narrative review on the current knowledge about Hypnic Headache with a focus on secondary Hypnic Headache. Methods Based on literature research, using Pubmed and Google Scholar, latest case reports, studies, and systematic reviews about Hypnic Headache were analyzed and summarized focusing on therapeutic options and causes of secondary Hypnic Headache. Conclusion Hypnic Headache mainly occurs in elderly patients. However, younger patients and children may also suffer from Hypnic Headache. Many different causes of secondary Hypnic Headache are described in the literature and ought to be ruled out before diagnosing primary Hypnic Headache. The pathophysiology of primary Hypnic Headache remains unclear, but a dysfunction of the hypothalamus seems to play a key role.

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Section: Discussionmentioning

confidence: 99%

“…A recent case report described episodes of hypoglycemia, during a 72-hour glucose monitoring period, related to the onset of HH attacks. Rescheduling the patient’s mealtime and increasing the calories at night resulted in a complete remission during a follow-up for 12 months (41).…”

Section: Secondary Hh Syndromementioning

confidence: 99%

Hypnic Headache – What do we know in 2022?

et al. 2023

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“…It goes away with successful sleep apnea treatment. However, there are other disorders of homeostasis in which the patient is awakened at dawn with headache, but high blood pressure 24,25 and low blood glucose levels 26 rule out hypnic headache.…”

Section: Asaamentioning

confidence: 99%

Secondary hypnic headache: A literature review in the last 34 years

Fortes¹,

Erudilho²,

Silva³

et al. 2022

Headache Med

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Introduction: Hypnic headache is a rare primary headache disorder that occurs during sleep. Its pathophysiology is uncertain, but hypothalamic dysfunction is hypothesized. It is usually a primary headache, but it can have secondary causes. Objectives: We aimed was to review articles published in the last 34 years on hypnic headache and analyze secondary cases. Methods: Based on a literature search in the major medical databases and using the descriptor “hypnic headache” we included articles published between 1988 and 2020. Of the 359 patients found, only 18 met the inclusion criteria and were analyzed. Results: We found 18 patients (6 men and 12 women) with secondary hypnic headache. The mean age of patients was 58.7±15.0 years, ranging from 20 to 84 years. The causes of hypnic headache were attributed to cranial vascular disorder (five), to non-vascular intracranial disorder (six), to a substance or its withdrawal (three) and to disorder of homoeostasis (four). Conclusions: Although most cases of hypnic headache are primary, some symptomatic cases are described in the literature.

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“…The International Headache Society suggests that the following criteria must be met for the headache to be diagnosed as HH (3): (1) it develops only during sleep and causes awakening, (2) it occurs for 10 days/month for >3 months, (3) it lasts from 15 min up to 4 h after awakening, and (4) there are no cranial autonomic symptoms or restlessness, according to the International Classification of Headache Disorders, 3rd edition (ICHD-3). The diagnosis of HH requires the exclusion of secondary causes of nocturnal headaches, such as nocturnal hypertension (4), hypoglycemia (5), auditory neuroma (6), and influenza A virus infection (7). Cervicogenic headaches can also awaken older adults from sleep.…”

Section: Introductionmentioning

confidence: 99%

Case report: Hypnic headache responds to agomelatine–a potential prophylactic treatment option

Sun

et al. 2023

Front. Neurol.

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IntroductionHypnic headache (HH) is a rare primary headache that is characterized by strict sleep-related attacks. However, the pathophysiology of HH remains unclear. The nocturnal nature of this activity suggests a hypothalamic involvement. The pathogenesis of HH may involve the brain structure that regulates circadian rhythms and is related to an imbalance between hormones, such as melatonin and serotonin. Currently, evidence-based medicine for HH pharmacotherapy is lacking. Acute and prophylactic treatment of HH is based on only a few case reports. Here, we report a case study in which agomelatine showed desirable responsiveness for the prophylactic treatment of HH for the first time.Case descriptionWe present the case of a 58-year-old woman with a 3-year history of nocturnal left temporal pain that awakened her during the wee hours. Brain magnetic resonance imaging did not reveal any midline structural abnormalities associated with circadian rhythms. Polysomnography revealed headache-related awakening at approximately 5:40 am, after the last rapid eye movement phase. No sleep apnea-hypopnea events were observed, without oxygen saturation or blood pressure abnormalities. The patient was prescribed agomelatine 25 mg at bedtime as a prophylactic treatment. In the following month, the frequency and severity of the headaches decreased by 80%. After 3 months, the patient’s headache completely resolved, and the medication was discontinued.ConclusionHH only occurs during sleep in the real world, leading to substantial sleep disturbances in older populations. Headache center neurologists need to focus on the prophylactic treatment of patients before bedtime to avoid nocturnal awakening. Agomelatine is a potential prophylactic treatment option for patients with HH.

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Hypnic Headache Due to Hypoglycemia: A Case Report

Cited by 9 publications

References 26 publications

Hypnic Headache – What do we know in 2022?

Hypnic Headache – What do we know in 2022?

Secondary hypnic headache: A literature review in the last 34 years

Case report: Hypnic headache responds to agomelatine–a potential prophylactic treatment option

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