title: Case Report: Coexistence of SUNCT and Hypnic Headache in the Same Patient.
abstract: BACKGROUND
  Short-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.
  
  
  METHODS
  A 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Department of Medical, Surgical and Health Sciences, Neurologic Clinic, Headache Centre, University of Trieste, Cattinara Hospital, Trieste, Italy.. jacopo.fantini@gmail.com.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Fantini
authors.affiliation: Department of Medical, Surgical and Health Sciences, Neurologic Clinic, Headache Centre, University of Trieste, Cattinara Hospital, Trieste, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Granato
authors.affiliation: Department of Medical, Surgical and Health Sciences, Neurologic Clinic, Headache Centre, University of Trieste, Cattinara Hospital, Trieste, Italy.
authors.forename: Marino
authors.initials: M
authors.lastname: Zorzon
authors.affiliation: Department of Medical, Surgical and Health Sciences, Neurologic Clinic, Headache Centre, University of Trieste, Cattinara Hospital, Trieste, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Manganotti
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D050798:SUNCT Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology
keywords: caffeine; hypnic headache; short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing; tautonomic; trigeminal