A review of 50 cases of bath-related headache: clinical features and possible diagnostic criteria.

OBJECTIVE

To describe clinical features and possible diagnostic criteria of the 50 bath-related headache (BRH) cases that have been published in the literature to date.

METHODS

Based on a literature search in the major medical databases, we analyzed all case reports or case series on BRH that were published between 2000 and 2017.

RESULTS

We describe 48 women and two men diagnosed with BRH. Of these 50 patients, 90% were from Asian countries. The average age was 49.3 years. There was an association of BRH with migraine (28%), tension-type headache (12%) and cold stimulus headache (4%). Headache was bilaterally localized, had an explosive or pulsating quality and a severe intensity. The pain lasted from five minutes to four days. Associated manifestations were nausea, vomiting, photophobia or phonophobia. There was a good therapeutic response with nimodipine and when avoiding a hot bath.

CONCLUSIONS

Bath-related headache is a benign headache that is not associated with a structural lesion.