Topiramate for the Treatment of Hypnic Headache: A Case Report, Including Polysomnography

Hypnic headache is a primary, rare headache disorder of the elderly, which occurs during sleep. Polysomnography (PSG) studies have shown that hypnic headache occurs with much gretaer frequency during REM sleep than during non-REM sleep. We present a 69-year-old male that had been waking from sleep d...

Full description

Bibliographic Details
Main Authors: Meliha Tan, Sibel Karaca, Başak Karakurum Göksel, Mehmet Ali Habeşoğlu
Format: Article
Language:English
Published: Galenos Yayinevi 2009-09-01
Series:Türk Nöroloji Dergisi
Subjects:
Online Access:http://www.tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-48615
_version_ 1797914370141847552
author Meliha Tan
Sibel Karaca
Başak Karakurum Göksel
Mehmet Ali Habeşoğlu
author_facet Meliha Tan
Sibel Karaca
Başak Karakurum Göksel
Mehmet Ali Habeşoğlu
author_sort Meliha Tan
collection DOAJ
description Hypnic headache is a primary, rare headache disorder of the elderly, which occurs during sleep. Polysomnography (PSG) studies have shown that hypnic headache occurs with much gretaer frequency during REM sleep than during non-REM sleep. We present a 69-year-old male that had been waking from sleep due to headaches that have occurred every night for 10 years and was diagnosed as hypnic headache according to International Headache Society (IHS) criterion. He did not benefit from lithium treatment. After taking topiramate 100 mg/day his headaches disappeared. PSG recordings made while he was taking topiramate showed that he had no headaches. He discontinued topiramate on his own and his headaches returned. Subsequently, three weeks after he stopped taking topiramate, two hypnic attacks were recorded during a second PSG-1 during REM and 1 during non-REM sleep. In two records, both the duration of REM and non-REM sleep were reduced. PSG while the patient was taking topiramate showed a higher proportion of REM sleep and fewer awakenings than did the second PSG. Our findings support the view that hypnic headache attacks arise directly from sleep, not from sleep stages. Changes in sleep physiology in the elderly may contribute to hypnic headache. Topiramate may be an effective alternative treatment for hypnic headache in cases unresponsive to lithium or in those that experience intolerable side-effects
first_indexed 2024-04-10T12:25:47Z
format Article
id doaj.art-9eb9a1f05a284d84a8d54c678a6f7bf2
institution Directory Open Access Journal
issn 1301-062X
1309-2545
language English
last_indexed 2024-04-10T12:25:47Z
publishDate 2009-09-01
publisher Galenos Yayinevi
record_format Article
series Türk Nöroloji Dergisi
spelling doaj.art-9eb9a1f05a284d84a8d54c678a6f7bf22023-02-15T16:15:13ZengGalenos YayineviTürk Nöroloji Dergisi1301-062X1309-25452009-09-01153140144Topiramate for the Treatment of Hypnic Headache: A Case Report, Including PolysomnographyMeliha Tan0Sibel Karaca1Başak Karakurum Göksel2Mehmet Ali Habeşoğlu3Adana Teaching And Medical Research Center, Faculty Of Medicine, University Of Baskent, Department Of Neurology, Adana, TurkeyAdana Teaching And Medical Research Center, Faculty Of Medicine, University Of Baskent, Department Of Neurology, Adana, TurkeyAdana Teaching And Medical Research Center, Faculty Of Medicine, University Of Baskent, Department Of Neurology, Adana, TurkeyAdana Teaching And Medical Research Center, Faculty Of Medicine, University Of Baskent, Department Of Chest Diseases, Adana, TurkeyHypnic headache is a primary, rare headache disorder of the elderly, which occurs during sleep. Polysomnography (PSG) studies have shown that hypnic headache occurs with much gretaer frequency during REM sleep than during non-REM sleep. We present a 69-year-old male that had been waking from sleep due to headaches that have occurred every night for 10 years and was diagnosed as hypnic headache according to International Headache Society (IHS) criterion. He did not benefit from lithium treatment. After taking topiramate 100 mg/day his headaches disappeared. PSG recordings made while he was taking topiramate showed that he had no headaches. He discontinued topiramate on his own and his headaches returned. Subsequently, three weeks after he stopped taking topiramate, two hypnic attacks were recorded during a second PSG-1 during REM and 1 during non-REM sleep. In two records, both the duration of REM and non-REM sleep were reduced. PSG while the patient was taking topiramate showed a higher proportion of REM sleep and fewer awakenings than did the second PSG. Our findings support the view that hypnic headache attacks arise directly from sleep, not from sleep stages. Changes in sleep physiology in the elderly may contribute to hypnic headache. Topiramate may be an effective alternative treatment for hypnic headache in cases unresponsive to lithium or in those that experience intolerable side-effectshttp://www.tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-48615Hypnic disordersprimarypolysomnographytopiramate
spellingShingle Meliha Tan
Sibel Karaca
Başak Karakurum Göksel
Mehmet Ali Habeşoğlu
Topiramate for the Treatment of Hypnic Headache: A Case Report, Including Polysomnography
Türk Nöroloji Dergisi
Hypnic disorders
primary
polysomnography
topiramate
title Topiramate for the Treatment of Hypnic Headache: A Case Report, Including Polysomnography
title_full Topiramate for the Treatment of Hypnic Headache: A Case Report, Including Polysomnography
title_fullStr Topiramate for the Treatment of Hypnic Headache: A Case Report, Including Polysomnography
title_full_unstemmed Topiramate for the Treatment of Hypnic Headache: A Case Report, Including Polysomnography
title_short Topiramate for the Treatment of Hypnic Headache: A Case Report, Including Polysomnography
title_sort topiramate for the treatment of hypnic headache a case report including polysomnography
topic Hypnic disorders
primary
polysomnography
topiramate
url http://www.tjn.org.tr/jvi.aspx?pdir=tjn&plng=eng&un=TJN-48615
work_keys_str_mv AT melihatan topiramateforthetreatmentofhypnicheadacheacasereportincludingpolysomnography
AT sibelkaraca topiramateforthetreatmentofhypnicheadacheacasereportincludingpolysomnography
AT basakkarakurumgoksel topiramateforthetreatmentofhypnicheadacheacasereportincludingpolysomnography
AT mehmetalihabesoglu topiramateforthetreatmentofhypnicheadacheacasereportincludingpolysomnography