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Revista de Neurologia Aug 2022Headache is one of the most frequent reasons for medical consultation. The SUNCT type is classified as a primary trigeminal-autonomic headache and should be considered...
INTRODUCTION
Headache is one of the most frequent reasons for medical consultation. The SUNCT type is classified as a primary trigeminal-autonomic headache and should be considered in cases of short-lasting, hemifacial pain associated with autonomic dysfunction. Additionally, in the approach to this disease, secondary causes that facilitate its onset must be ruled out.
CASE REPORT
We describe a case of a new-onset SUNCT-type headache in which involvement of the first branch of the trigeminal nerve due to herpes zoster virus infection was documented six days after the onset of pain.
CONCLUSION
Trigeminal autonomic headaches are usually primary; yet, multiple conditions have been described that are associated with SUNCT-type headaches and have a secondary etiology. Among these, herpes zoster virus infection should be considered at the onset of episodes consistent with SUNCT-type headache unresponsive to medical treatment.
Topics: Herpes Zoster; Humans; SUNCT Syndrome
PubMed: 35879882
DOI: 10.33588/rn.7503.2021410 -
Arquivos de Neuro-psiquiatria Sep 2003The SUNCT syndrome is characterized by a short-lasting headache in the first division of the trigeminal nerve, associated with ipsilateral autonomic symptoms. It is... (Review)
Review
The SUNCT syndrome is characterized by a short-lasting headache in the first division of the trigeminal nerve, associated with ipsilateral autonomic symptoms. It is highly refractory to prophylactic medication. We describe a case where lamotrigine reduced the intensity, duration, and frequency of attacks and increased the remission period of this disorder. Over a two-year period, the attacks came back immediately whenever the patient reduced the dose or neglected treatment. We concluded that lamotrigine is effective in treating SUNCT syndrome when used in high doses for a prolonged period of time.
Topics: Analgesics; Headache; Humans; Lamotrigine; Male; Middle Aged; Syndrome; Triazines
PubMed: 14513183
DOI: 10.1590/s0004-282x2003000400032 -
The Journal of Headache and Pain Aug 2010Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is one of the rarest and most serious headache disorders. Cases of...
Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is one of the rarest and most serious headache disorders. Cases of symptomatic SUNCT syndromes are reported, which demonstrate that brain imaging is very important for diagnosis. In this study, we describe the first case of secondary SUNCT syndrome caused by a meningioma. So far, a clearly effective therapy for SUNCT syndrome has not been known. In this case, however, SUNCT was completely responsive to gabapentin. This underlines that this drug is worthy of being considered as a potential therapeutic option in the treatment of SUNCT syndrome.
Topics: Aged, 80 and over; Amines; Analgesics; Cyclohexanecarboxylic Acids; Female; Gabapentin; Humans; Meningeal Neoplasms; Meningioma; SUNCT Syndrome; gamma-Aminobutyric Acid
PubMed: 20428918
DOI: 10.1007/s10194-010-0216-1 -
The Journal of Headache and Pain Mar 2012Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform attacks with cranial autonomic...
BACKGROUND
Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform attacks with cranial autonomic features (SUNA) are rare primary headache syndromes characterized by spontaneous or triggered attacks of unilateral, brief, multiple, orbitofrontal pain associated with ipsilateral autonomic features. SUNCT is considered as a subset of SUNA. In SUNA, there may be cranial autonomic symptoms other than conjunctival injection and lacrimation, or either of two is present. SUNCT/SUNA can be triggered immediately after or at the decrescendo phase of the ongoing attack without any intervening refractory period. Refractory period is usually present in trigeminal neuralgia. Absent refractory period is thought to reliably differentiate SUNCT/SUNA from trigeminal neuralgia and has been proposed for inclusion into the International Classification of Headache Disorders (ICHD) diagnostic criteria for SUNCT.
CASE REPORTS
We report three patients of SUNCT syndrome with preserved intervening refractory period of variable duration observed at different times.
DISCUSSION
Trigeminal neuralgias with autonomic features, SUNA and SUNCT share a common pathophysiological mechanism and actually represent a continuum. It is well known that patient with trigeminal neuralgia may transform into SUNCT/SUNA. Similarly, being a continuum, the presence or the absence of refractory period and its duration may change in a patient with SUNCT/SUNA at different time points.
CONCLUSION
The presence of refractory period should not exclude the diagnosis of SUNCT in a patient with other clinical features suggestive of SUNCT.
Topics: Humans; Male; Middle Aged; Refractory Period, Electrophysiological; SUNCT Syndrome
PubMed: 22227716
DOI: 10.1007/s10194-011-0412-7 -
Journal of Neurology, Neurosurgery, and... Sep 2010Medical management of short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome and short-lasting unilateral neuralgiform...
BACKGROUND
Medical management of short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) is often unsatisfactory.
METHODS
The authors report nine cases of SUNCT/SUNA that failed medical treatment and had an aberrant arterial loop either in contact with or compressing the appropriate trigeminal nerve demonstrated on MRI. All underwent microvascular decompression of the ipsilateral trigeminal nerve for intractable pain.
RESULTS
Immediate and complete relief of SUNCT and SUNA symptoms occurred in 6/9 (67%) cases. This was sustained for a follow-up period of 9-32 months (mean 22.2). In 3/9 (33%) cases, there was no benefit. Ipsilateral hearing loss was observed in one case.
CONCLUSION
Medically intractable SUNCT and SUNA subjects with a demonstrable aberrant arterial loop impinging on the trigeminal nerve on neuroimaging may benefit from microvascular decompression.
Topics: Aged; Decompression, Surgical; Female; Humans; Magnetic Resonance Imaging; Male; Microvessels; Middle Aged; SUNCT Syndrome; Trigeminal Autonomic Cephalalgias; Trigeminal Nerve
PubMed: 20462914
DOI: 10.1136/jnnp.2009.182824 -
Agri : Agri (Algoloji) Dernegi'nin... Jan 2018Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare, primary headache syndrome, which is classified as a...
Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare, primary headache syndrome, which is classified as a subtype of trigeminal autonomic cephalalgias. Although SUNCT is usually refractory to treatment, several antiepileptic drugs have recently shown promising results for its treatment. However, there is a lack of evidence regarding the course of SUNCT during pregnancy and the available treatment options. Here, we present a 30-week pregnant female with SUNCT who was successfully treated with infra- and supraorbital nerve blocks. Headache attacks completely diminished after the injection, and recurrence was not observed. Although lamotrigine may be relatively safe in pregnant patients with SUNCT attacks, peripheral nerve block may be a feasible technique and can be considered as a safe and effective treatment option. This is the first SUNCT case in the literature that was successfully treated with infra- and supraorbital nerve blocks during pregnancy.
Topics: Adult; Anticonvulsants; Diagnosis, Differential; Female; Headache; Humans; Lamotrigine; Nerve Block; Neuralgia; Pregnancy; Pregnancy Complications; Prenatal Diagnosis; Triazines
PubMed: 29450873
DOI: 10.5505/agri.2016.25991 -
The Journal of Headache and Pain Apr 2011Chronic paroxysmal hemicrania (CPH) is a rare primary headache syndrome, which is classified along with hemicrania continua and short-lasting unilateral neuralgiform...
Chronic paroxysmal hemicrania (CPH) is a rare primary headache syndrome, which is classified along with hemicrania continua and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) as trigeminal autonomic cephalalgia (TACs). CPH is characterised by short-lasting (2-30 min), severe and multiple (more than 5/day) pain attacks. Headache is unilateral, and fronto-orbital-temporal pain is combined with cranial autonomic symptoms. According to the International Classification of Headache Disorders, 2nd edition, the attacks are absolutely responsive to indomethacin. CPH has been only rarely and incompletely described in the developmental age. Here, we describe two cases concerning a 7-year-old boy and a 11-year-old boy with short-lasting, recurrent headache combined with cranial autonomic features. Pain was described as excruciating, and was non-responsive to most traditional analgesic drugs. The clinical features of our children's headache and the positive response to indomethacin led us to propose the diagnosis of CPH. Therefore, our children can be included amongst the very few cases of this trigeminal autonomic cephalgia described in the paediatric age.
Topics: Age Factors; Anti-Inflammatory Agents, Non-Steroidal; Child; Cyclooxygenase Inhibitors; Drug Administration Schedule; Humans; Indomethacin; Male; Paroxysmal Hemicrania; Secondary Prevention; Trigeminal Autonomic Cephalalgias
PubMed: 21340658
DOI: 10.1007/s10194-011-0315-7 -
Noro Psikiyatri Arsivi Jun 2016
PubMed: 28360795
DOI: 10.5152/npa.2015.10266 -
The Journal of Headache and Pain Aug 2012
Topics: Humans; Male; Refractory Period, Electrophysiological; SUNCT Syndrome
PubMed: 22665021
DOI: 10.1007/s10194-012-0463-4 -
The Journal of Headache and Pain Feb 2009SUNCT is a syndrome of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing. We are presenting now two cases absolutely...
SUNCT is a syndrome of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing. We are presenting now two cases absolutely responders to steroid therapy, one of them a SUNCT-like secondary to a prolactinoma and the other primary.
Topics: Conjunctiva; Conjunctival Diseases; Humans; Male; Middle Aged; Prolactinoma; SUNCT Syndrome; Steroids; Treatment Outcome
PubMed: 19020800
DOI: 10.1007/s10194-008-0080-4