To report a case series of sneezing systematically occurring in two cases with migraine and cranial autonomic symptoms and two with cluster headache.
Sneezing occurring systematically during cluster headache or migraine is a rare condition. Sneezing has been described as a specific trigger for migraine.
We describe four patients with primary headaches, presenting systematic sneezing at a definite time of premonitory, postdromal, or headache phase. All of these headaches were associated with cranial autonomic symptoms.
Sneezing is a symptom associated with primary headaches. The definite place of sneezing in these patients suggests a particular implication of hypothalamus in the pathophysiology of these cases.