title: Migraine after sneezing: pathophysiological considerations, focused on the difference with coughing.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Neurology, Leiden University Medical Centre, Leiden 2300 RC, The Netherlands. w.p.j.van_oosterhout@lumc.nl
authors: Willebordus P J
authors: WP
authors: van Oosterhout
authors: Joost
authors: J
authors: Haan
mesh_terms: D000328:Adult; D003371:Cough / Q000150:complications* / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis* / Q000209:etiology*; D012912:Sneezing
keywords: cough headache; migraine; sneezing; thunderclap headache; trigger factor