Exploding Head SyndromeThe Exploding Head Syndrome (EHS) used to be called "snapping of the brain", but the first detailed descriptions were published in 1989. This disorder can occur during any phase of sleep - from slow wave sleep to REM phase sleep. The patient will usually describe a loud explosion - like a bomb going off - which will cause them to startle from sleep. The sufferer is often very frightened by the experience, and attacks can occur several times each night or many nights in a row. The disorder is not associated with any serious underlying disease - brain scans are normal in most cases. The symptoms can occur at any age (although my patients have usually been older i.e. >50 years), and in males or females. In the original detailed description of 1989, other phenomena occurred - tinnitus, a flash of light - a feeling of the heart racing - or a sensation of being unable to get a breath - and often people with exploding head symptoms were under periods of significant work related stress. There is a recent case report of exploding head symptoms followed by sleep paralysis (another sleep disorder) and then by migraine headache. Migraine is probably more common in "exploders", but the significance of the potential link with migraine headache is not clear. Treatment with medication can usually be avoided as an explanation is usually enough. However, people have reported success control of frequent symptoms with the use of tricyclic anti-depressants like imipramine, or calcium antagonists like nifedipine or flunarizine. ReferencesPearce JM Clinical features of the EHS.Journal of Neurology Neurosurgery and Psychiatry. 1989;52:907–910 (Free Full text).Sachs and Svanborg. EHS: polysomnographic recordings and therapeutic suggestions.Sleep 1991;14:263-6 (Free Abstract Only). Jaeome DE. EHS and idiopathic stabbing headache relieved by nifedipine. Cephalalgia 2001; 21:617–18 (Free Abstract Only) A Chakravarty EHS: report of two new casesCephalalgia 2008;28:399-400 (Free Abstract Only) Evans RW. EHS Followed by Sleep Paralysis: A Rare Migraine AuraHeadache 2006;46:682-683 (Free Abstract Only)
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