exploding head syndrome
A popular term for a type of hypnagogic auditory hallucination in which a person perceives one or more very loud noises which he or she likens to an explosion, crashing waves, screams or clanging, often accompanied by flashes of light but not pain, that seem to come from inside his/her head. The attacks can occur as one-offs or recur, in some cases increasing with time. The attacks typically occur shortly after falling asleep, are clustered over several days to weeks followed by months of remission and are not linked to dreams, as they may occur whilst awake. They are more common when the patient is stressed or exhausted.
Post-attack findings Tachycardia, dyspnoea, hearing loss, tinnitus, palpitations and anxiety.
Demographics The condition typically affects those over age 50–but may affect children and adolescents, and is more common in women.
Pathogenesis Unknown; ? inner ear dysfunction, ? epilepsy, ? withdrawal from selective serotonin re-uptake inhibitors–SSRIs
Management None known to be effective; it may remit spontaneously.