Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2017 Jul 25;10(1):318.
doi: 10.1186/s13104-017-2641-6.

Case report of hypnic headache: a rare headache disorder with nocturnal symptoms

Kanishka P Dissanayake  1 , Damindi P Wanniarachchi  2 , Udaya K Ranawaka  3
Affiliations
Case Reports

Case report of hypnic headache: a rare headache disorder with nocturnal symptoms

Kanishka P Dissanayake et al. BMC Res Notes. .

Abstract

Background: Headache is one of the commonest complaints reported to physicians worldwide. Yet, arriving at the proper diagnosis can be a challenge in many patients. Although most headaches belong to common categories of migraine and tension-type headache, which are diagnosed and managed relatively easily, several uncommon headache disorders can lead to delays in diagnosis. Certain medications are more efficacious than others in managing these headache disorders, hence establishing the correct diagnosis is of paramount importance.

Case presentation: An 86-year-old female presented with chronic daily headache of 1 year duration. Her headaches were exclusively nocturnal and woke her up daily around midnight. Clinical examination was unremarkable. All basic investigations were normal. Subsequent gadolinium enhanced Magnetic Resonance Imaging (MRI) brain did not show any significant pathology. There was no satisfactory response to paracetamol, diclofenac sodium, mefenamic acid, tramadol, flunarizine and sodium valproate. Indomethacin was started with the provisional diagnosis of hypnic headache. There was absolute response by day 3 of indomethacin. She remains headache free on low dose indomethacin maintenance at 1 year after the diagnosis.

Conclusion: Better understanding of uncommon headache syndromes can help in early diagnosis and appropriate treatment. Hypnic headache should be considered in the differential diagnosis of chronic daily headaches, especially when nocturnal and occurs during sleep.

Keywords: Case report; Headache; Hypnic headache; Nocturnal headache.

PubMed Disclaimer

References

    1. Stefan E, Peter JG. Hypnic headache. Pract Neurol. 2005;5:144–49. http://pn.bmj.com/content/5/3/144.full.pdf. Accessed 15 March 2016.
    1. Patsouros N, Laloux P, Ossemann M. Hypnic headache: a case report with polysomnography. Acta Neurol Belg. 2004;104:37–40. http://www.actaneurologica.be/acta/download/2004-1/07-Patsouros%20et%20a.... Accessed 15 March 2016. - PubMed
    1. Diener HC, Obermann M, Holle D. Hypnic headache: clinical course and treatment. Curr Treat Options Neurol. 2012;14(1):15–26. doi:10.1007/s11940-011-0156-3. http://www.ncbi.nlm.nih.gov/pubmed/22072057. Accessed 16 March 2016. - PubMed
    1. Kerr E, Hewitt R, Gleadhill I. Benign headache in the elderly—a case report of hypnic headache. Ulster Med J. 2006;75(2):158–59. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1891726/ Accessed 16 March 2016. - PMC - PubMed
    1. International Headache Society Classification ICHD 3-beta. https://www.ichd-3.org/other-primary-headache-disorders/4-9-hypnic-heada.... Accessed 07 January 2017.

Publication types

LinkOut - more resources