We have examined the most intense external (magnetospheric and ionospheric) and internal (induced) |dH/dt| (amplitude of the 10gs time derivative of the horizontal geomagnetic field) events observed by the high-latitude International Monitor for Auroral Geomagnetic Effects (IMAGE) magnetometers between 1994 and 2018. While the most intense external |dH/dt| events at adjacent stations typically occurred simultaneously, the most intense internal (and total) |dH/dt| events were more scattered in time, most likely due to the complexity of induction in the conducting ground. The most intense external |dH/dt| events occurred during geomagnetic storms, among which the Halloween storm in October 2003 featured prominently, and drove intense geomagnetically induced currents (GICs). Events in the prenoon local time sector were associated with sudden commencements (SCs) and pulsations, and the most intense |dH/dt| values were driven by abrupt changes in the eastward electrojet due to solar wind dynamic pressure increase or decrease. Events in the premidnight and dawn local time sectors were associated with substorm activity, and the most intense |dH/dt| values were driven by abrupt changes in the westward electrojet, such as weakening and poleward retreat (premidnight) or undulation (dawn). Despite being associated with various event types and occurring at different local time sectors, there were common features among the drivers of most intense external |dH/dt| values: preexisting intense ionospheric currents (SC events were an exception) that were abruptly modified by sudden changes in the magnetospheric magnetic field configuration. Our results contribute towards the ultimate goal of reliable forecasts of dH/dt and GICs.