Migraine after sneezing: pathophysiological considerations, focused on the difference with coughing

Headache. Jul-Aug 2013;53(7):1147-51. doi: 10.1111/head.12060. Epub 2013 Feb 20.


Introduction: 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.

Case report: 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.

Discussion: 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.

Keywords: cough headache; migraine; sneezing; thunderclap headache; trigger factor.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cough / complications*
  • Cough / diagnosis*
  • Diagnosis, Differential
  • Humans
  • Male
  • Migraine Disorders / diagnosis*
  • Migraine Disorders / etiology*
  • Sneezing*