Exploding head syndrome (EHS) attacks are characterized by the sensation of 
sudden loud banging noises, and are occasionally accompanied by the sensation of 
a flash light. Although these attacks in themselves are usually not painful, it 
is reported that EHS attacks may precede migraines and may be perceived as 
auras. A 53-year-old woman, with a 40-year history of fulgurating migraines, 
experienced 2 different types of EHS attacks. During most of the attacks, which 
were not painful, she heard sounds like someone yelling or cars passing by. Only 
1 episode was accompanied with the sensation of a flash light and of sounds 
similar to those of an electrical short circuit. On the video-polysomnography, 
video-polysomnography showed 11 EHS attacks occurred during stage N1 and stage 
N2; these attacks were preceded by soft snoring. She also had moderate 
obstructive sleep apnea syndrome (Apnea Hypopnea Index: 16.7) for which an oral 
appliance was prescribed; the EHS attacks did not recur after this treatment. 
The pathophysiology of EHS is still unclear. A detailed analysis of PSG data may 
help in understanding the pathophysiology of this syndrome and also in the 
selection of therapeutic strategies.