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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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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author Smit Firke
Bhagyesh Sapkale
Gargi Mudey
Sachin R Gedam
author_facet Smit Firke
Bhagyesh Sapkale
Gargi Mudey
Sachin R Gedam
author_sort Smit Firke
collection DOAJ
description 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.
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spelling doaj-art-c140fddac7e744fd823beaf42cfb0b702025-08-20T03:03:36ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-03-01193010410.7860/JCDR/2025/74524.20723Unraveling the Mysteries of Exploding Head Syndrome: A Narrative ReviewSmit Firke0Bhagyesh Sapkale1Gargi Mudey2Sachin R Gedam3Undergraduate Student, Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India.Undergraduate Student, Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India.Professor, Department of Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India.Assistant Professor, Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India.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.https://jcdr.net/articles/PDF/20723/74524_CE[Ra1]_F(IS)_QC(PS_SHU)_PF1(JY_SS)_PFA_NC(IS)_PN(IS).pdfauditory hallucinationsparasomniaspsychological stresstemporal lobe seizuressleep disorderssleep-wake transition
spellingShingle Smit Firke
Bhagyesh Sapkale
Gargi Mudey
Sachin R Gedam
Unraveling the Mysteries of Exploding Head Syndrome: A Narrative Review
Journal of Clinical and Diagnostic Research
auditory hallucinations
parasomnias
psychological stress
temporal lobe seizures
sleep disorders
sleep-wake transition
title Unraveling the Mysteries of Exploding Head Syndrome: A Narrative Review
title_full Unraveling the Mysteries of Exploding Head Syndrome: A Narrative Review
title_fullStr Unraveling the Mysteries of Exploding Head Syndrome: A Narrative Review
title_full_unstemmed Unraveling the Mysteries of Exploding Head Syndrome: A Narrative Review
title_short Unraveling the Mysteries of Exploding Head Syndrome: A Narrative Review
title_sort unraveling the mysteries of exploding head syndrome a narrative review
topic auditory hallucinations
parasomnias
psychological stress
temporal lobe seizures
sleep disorders
sleep-wake transition
url 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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