Hypnic headache in children

Background: Hypnic headache (HH) is a rare, short-lasting headache occurring exclusively during sleep and usually affecting the elderly population. According to the ICHD-II diagnostic criteria, HH is characterized exclusively by sleep-related dull headache attacks, either lateralized or bilateral, a recurrence of > 15 times per month and a persistence of pain > 15 minutes after waking. No autonomic symptoms and no more than nausea, photophobia, or phonophobia are present. Cases: We report three children between 7 and 11 years old with HH features. The characteristics of our patient's headache, with particular reference to the nocturnal pattern, the short duration and the absence of autonomic symptoms, lead us to consider the diagnosis of HH. Conclusions: Considering the very few cases of HH reported in paediatric age, our cases may expand the clinical spectrum of this disorder, suggesting a possible revision of the diagnostic criteria, with particular regard to the developmental age.