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Keywords:

  • migraine;
  • trigger factor;
  • sneezing;
  • cough headache;
  • thunderclap headache

Introduction

In patients reporting acute headache after sneezing or coughing, rupture of an intracranial aneurysm is the first diagnosis to be considered. Sneezing, however, might also be a trigger for migraine attacks, as exemplified in our case.

Case Report

We describe a patient who suffered 3 headache attacks after sneezing, each fulfilling criteria of migraine without aura. Sneezing as a specific trigger for migraine has not been described before.

Discussion

The differential diagnosis of acute headache after sneezing (eg, subarachnoid hemorrhage and reversible cerebral vasoconstriction), and the differences between migraine after sneezing and “benign cough headache” are discussed. We conclude that a pathophysiological association between migraine and sneezing might exist and hypothesize on underlying mechanisms.