A Consecutive Series of 22 Cases of Hypnic Headache in France

Abstract

A series of 22 patients was consecutively diagnosed with hypnic headache (HH) from June 2007 to June 2008 in two headache specialty centres participating in the French Observatory of Migraine and Headaches. Patients and headache characteristics were compared with the 2004 International Classification of Headache Disorders, 2nd edn (ICHD-II) criteria for HH and published series of HH patients. One-third of HH patients reported migraine-like headaches (pulsating/unilateral/stabbing) and > 20% were aged < 50 years at symptom onset. Of note, HH patients displayed typical motor activities during the headache (getting up, eating/drinking especially a cup of coffee, reading/watching television) that differentiate HH from migraine and suggest relationships between HH and trigeminal autonomic cephalalgias. The functional and emotional impact of HH appears low and similar to that of migraine in patients consulting in primary care practice. Improvements in ICHD-II criteria are suggested, especially to introduce the typical motor behaviour acted out by HH patients.

From Wakefulness to Sleep: Migraine and Hypnic Headache Association in a Series of 23 Patients

“…Contrarily to the initial description by Raskin, HH is more frequent in female patients, as is also observed in our series. Hypnic headache usually begins after age 50 years, as it was considered in ICHD‐II, but it has been described in younger patients …”

The Hypothalamus: Specific or Nonspecific Role in the Pathophysiology of Trigeminal Autonomic Cephalalgias?

“…Recent VBM data showed a gray matter decrease in the posterior hypothalamus close to the region of gray matter increase observed in CH [44]. Even though HH is not classified as TAC, it is noteworthy that a significant number of patients report accompanying trigeminal autonomic symptoms during their headache attacks [45,46]. To what extent this could be an explanation for the structural alterations of the hypothalamus still is unclear.…”

Tension-Type Headache Mimics

“…It is more common in women [40]. Most patients (59-70%) report a history of other primary headache disorders, most commonly migraine and TTH [40,41]. In polysomnography studies, attacks occur during rapid eye movement (REM) sleep, suggesting that HH might be due to activation of nociceptive areas in the brainstem during sleep [40].…”