Unraveling the Mysteries of Exploding Head Syndrome: A Narrative Review

Exploding Head Syndrome (EHS) is a rare parasomnia characterised by the perception of loud, abrupt auditory hallucinations during sleep-wake transitions. Even though EHS is not associated with any physical pathology, it may cause substantial sleep disturbances and interruptions. To address these que...

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Bibliographic Details
Main Authors: Smit Firke, Bhagyesh Sapkale, Gargi Mudey, Sachin R Gedam
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2025-03-01
Series:Journal of Clinical and Diagnostic Research
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Online Access:https://jcdr.net/articles/PDF/20723/74524_CE[Ra1]_F(IS)_QC(PS_SHU)_PF1(JY_SS)_PFA_NC(IS)_PN(IS).pdf
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Summary:Exploding Head Syndrome (EHS) is a rare parasomnia characterised by the perception of loud, abrupt auditory hallucinations during sleep-wake transitions. Even though EHS is not associated with any physical pathology, it may cause substantial sleep disturbances and interruptions. To address these questions, the present narrative review synthesises the current knowledge and consensus on the nature of EHS, including its symptoms and possible causes, existing classification systems, and available interventions. Other frequent complaints include rhythmic noises in the ears, difficulty seeing and somatic sensations, such as electrical buzzing in the head. Stress or anxiety may potentially precede an episode, and dysfunction in the brainstem reticular formation and mild temporal lobe seizures have been suggested as possible neurological causes. EHS falls under the category of parasomnias within the International Classification of Sleep Disorders Third edition (ICSD-3) and is classified as an unspecified sleep-wake disorder under the Diagnostic and Statistical Manual of Mental Disorders Fifth edition (DSM-5). Current intervention strategies are still scarce; while topiramate has been shown to lessen the intensity of symptoms, no trials on this possibility have been conducted so far. Education and reassurance may be useful in alleviating these symptoms. More studies are required to increase knowledge about the underlying processes and to establish specific therapeutic strategies. The present review alerts readers to the growing evidence for EHS, which remains a condition that is not frequently identified, and urges investigators to conduct randomised controlled therapeutic trials.
ISSN:2249-782X
0973-709X