Exploding Head Syndrome - No pun required

This is an old post from my previous blog. Recently it has been seeing a lot of activity so I thought I'd play around with it a bit and re-post it here. Enjoy :)

Sometimes when searching for disease to write about a wonderful thing happens. The clouds part, cherubs descend, angels play intricate harp-based musical compositions, and a beam of light illuminates the link to a wonderful disease. This happened to me the other day, and now, without further ado, let me introduce you to Exploding Head Syndrome. Best. Disease. Name. Ever.

Acute Exploding Head Syndrome sufferer (screenshot from the 1981 movie Scanners)

Okay so heads don’t actually explode but sufferers seem to experience a simulated explosion in the form of an incredibly loud noise coming from inside their own head. This sound can take many forms from ringing and screaming to, of course, explosions. One patient even described the preceding whistle of dropping bombs, the explosion of shells, and then complete silence, similar to an experience she endured as a child during the Blitz in London.

Exploding Head Syndrome is related to equally terrifying syndromes called ‘ice-pick headache’ and ‘needle in the eye syndrome’ but each of those have a pain component where Exploding Head Syndrome doesn’t (I can’t help capitalising Exploding Head Syndrome, it just feels like it should carry capitals).

The syndrome itself is described as “harmless but frightening” for sufferers. I guess the sensation that your head is about to explode isn’t pleasant but frightening doesn’t seem to be enough of a word to describe the torment.

Just to up the scare factor of this syndrome it seems to be associated with sleep. In a case study published in the British Medical Journal a woman described her attacks as…:

“Being wakened by a sudden bang in the head, as if my head was bursting with a flash of light over both fields of vision, after which I would be dazed for a split second" [and then would] "Come round, terrified, my heart thumping. There was no pain, just a frightening sense of explosion.”

Wow.

So what’s happening? Nobody has any idea. It isn’t auditory because deaf sufferers have been reported. It’s not linked to random nerve firing (often reflected in a condition called myoclonic jerks). It’s not linked to epilepsy. It’s not linked to migraines.

So we can’t understand what causes it, we have no idea what’s happening, we can’t say what might trigger it, it doesn’t seem to correlate with any associated conditions, apart from sleep – there’s only one thing missing here. Can we cure it? Of course not, what are you, stoopid?

There have been some reports that sedatives help but also, confusingly, apparently so do stimulants. Anti-depressants apparently help but not in all cases. The best bet for treatment seems to be to let it go away on its own. Many recorded cases had an acute onset where every night’s sleep was disrupted at least once and over a month to years the attacks became less frequent until they appeared to stop altogether.

I guess sufferers can take heart that if nothing else, being diagnosed with an Exploding Head makes for pretty interesting dinner party conversation!

Listerine - Insensitive to Exploding Head Syndrome sufferers since 1914

Chakravarty, A. (2008). Exploding head syndrome: report of two new cases Cephalalgia, 28 (4), 399-400 DOI: 10.1111/j.1468-2982.2007.01522.x
Evans RW, & Pearce JM (2001). Exploding head syndrome. Headache, 41 (6), 602-3 PMID: 11437900
Kallweit U, Khatami R, & Bassetti CL (2008). Exploding head syndrome--more than "snapping of the brain"? Sleep medicine, 9 (5) PMID: 17709298
Pearce JM (1989). Clinical features of the exploding head syndrome. Journal of neurology, neurosurgery, and psychiatry, 52 (7), 907-10 PMID: 2769286