• Jacopo Fantini, Antonio Granato, Marino Zorzon, and Paolo Manganotti.
• Department of Medical, Surgical and Health Sciences, Neurologic Clinic, Headache Centre, University of Trieste, Cattinara Hospital, Trieste, Italy.. jacopo.fantini@gmail.com.
• Headache. 2016 Oct 1; 56 (9): 1503-1506.

BackgroundShort-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and hypnic headache (HH) are two exceedingly rare and distinctly classified primary headaches. The hypothalamus seems to be a crucial region involved in the pathophysiology of both conditions, but no cases of SUNCT and HH co-occurrence have been described so far.Case ResultsA 49-year-old woman who has been suffering from SUNCT for years, with alternation of symptomatic periods and remissions, developed a new headache with different clinical features, presenting exclusively during sleep and with a dramatic responsiveness to caffeine, that met the diagnostic criteria for HH.ConclusionsThe available literature suggests that SUNCT and HH are different conditions but the association in the same patient that we describe supports the concept that they are not mutually exclusive. Further studies are needed to establish if they share a common pathophysiological mechanism.© 2016 American Headache Society.

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