Hypnic headache in childhood: A literature review

Hypnic headache (HH) is a rare benign disorder described initially by Raskin in 1988. It is characterized by recurrent nocturnal episodes of headache that periodically awaken the sleeping patient and usually occur in the elderly. This review is aimed at describing the clinical features of the HH cases in childhood that have been published in literature so far. Based on a literature search in the major medical databases (LiLacs, SciELO, Bireme, Scopus, EBSCO and PubMed), we have analyzed the case reports on HH in childhood that have been published between 1988 (the first description) and 2014. In this review, we have described five children (3 girls and 2 boys) diagnosed with HH. The average age was 9.0 ± 1.6 years (95% CI 7.6-10.4), ranging from 7 to 11 years. The diagnosis was made 15.8 ± 25.0 months (range 1 to 60 months) after the headache started. Three patients (60.0%) were awakened a few hours after falling asleep. The headache lasted up to 30 min in four (80.0%) patients. The headache was bilaterally localized (4/5; 80.0%), had a throbbing/pulsating character (3/5; 60.0%) and a severe intensity (4/5; 80.0%). The frequency was less than 15 days per month (4/5; 80.0%). The absence of autonomic symptoms was reported by all patients. There was successful treatment with melatonin in 2/5 (40.0%) of the patients. HH is very rare in childhood; its clinical features are inconsistent and still need further evaluation.