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Exploding head syndrome is a condition that causes the sufferer occasionally to experience a tremendously loud noise as originating from within his or her own head, usually described as the sound of an explosion, roar, waves crashing against rocks, loud voices or screams, a ringing noise, or the sound of an electrical short circuit (buzzing).

This noise usually occurs within an hour or two of falling asleep, but is not necessarily the result of a dream and can happen while awake as well.[1] Perceived as extremely loud, the sound is usually not accompanied by pain. Attacks appear to change in number over time, with several attacks occurring in a space of days or weeks followed by months of remission. Sufferers often feel a sense of fear and anxiety after an attack, accompanied by elevated heart rate. Attacks are also often accompanied by perceived flashes of light (when perceived on their own, known as a "visual sleep start") or difficulty in breathing. The condition is also known as "auditory sleep starts." It is not thought to be dangerous,[1] although it is sometimes distressing to experience.

Reference to the condition was made in an episode of the BBC TV drama "Doc Martin", which was instrumental in many sufferers becoming aware that the problem was in fact a known medical condition, and not one to be concerned about.

Contents

Causes

The cause of the exploding head syndrome (EHS) is not known, though some physicians have reported a correlation with stress or extreme fatigue. The condition may develop at any time during life and women suffer from it slightly more often than men.[citation needed] Attacks can be one-time events, or can recur.

The mechanism is also not known, though possibilities have been suggested; one is that it may be the result of a sudden movement of a middle ear component or of the eustachian tube, another is that it may be the result of a form of minor seizure in the temporal lobe where the nerve cells for hearing are located.[citation needed] Electroencephalograms recorded during actual attacks show unusual activity only in some sufferers, and have ruled out epileptic seizures as a cause.[2] But an attack must happen during an episode. If results are normal during the test, only then can epilepsy be completely ruled out.

SSRI withdrawals have been also known to caused similar phenomena (i.e. brain zaps).

Symptoms

Exploding head syndrome is a condition that causes the sufferer to occasionally experience a tremendously loud noise as originating from within his or her own head, usually described as the sound of an explosion, gunshot, door slamming, roar, waves crashing against rocks, loud voices, a ringing noise, or the sound of an electrical short circuit (buzzing). In some cases an instant flash of what is perceived as video "static" is reported.

This syndrome can also cause the sufferer to feel an extreme rush or adrenaline kick going through his or her head, sometimes multiple times. In most cases, it occurs when they are in a state between asleep and awake. Some sufferers report familiarisation with the subsequent fear or panic element such that they no longer consciously experience it.

In some cases repeated attacks lead to the sufferer gaining a fear of sleeping or resting, as this is the most common time for attacks to take place, and this can lead to the development of sleeping disorders such as insomnia.

Treatment

Symptoms may be resolved spontaneously over time. It may be helpful to reassure the patient that this symptom is harmless. Clomipramine has been used in three patients, who experienced immediate relief from this condition.[2]

See also

References

  1. ^ a b J M Pearce (1989), "Clinical features of the exploding head syndrome", Journal of Neurology Neurosurgery and Psychiatry 52 (7): 907–910 
  2. ^ a b Sachs, C; Svanborg E. (June 1991), "The exploding head syndrome: polysomnographic recordings and therapeutic suggestions", Sleep 14 (3): 263–6, PMID 1896728 

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