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Arquivos de Neuro-psiquiatria Jun 2006For twelve years, the subject of this report, a 38-year-old man, presented a clinical condition compatible with the SUNCT (short-lasting unilateral neuralgiform headache...
For twelve years, the subject of this report, a 38-year-old man, presented a clinical condition compatible with the SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) syndrome. He presented a stabbing and intense daily pain located in the left pre-auricular and temporal regions. Each of these intense pain attacks lasted around one minute and presented a frequency of two to eight times per day. The pain was associated with ipsilateral lacrimation, conjunctival injection and rhinorrhea. MRI revealed a pituitary tumor with little suprasellar extent. The subjects serial assays of prolactin, GH, TSH and ACTH were within normal levels. Following transsphenoidal hypophysectomy, with complete removal of the tumor, the subject no more presented pain. The pathological diagnosis was non-secreting adenoma. Fourteen months after the surgery, he remains symptom-free.
Topics: Adenoma; Adult; Humans; Hypophysectomy; Magnetic Resonance Imaging; Male; Pituitary Neoplasms; SUNCT Syndrome; Treatment Outcome
PubMed: 16917628
DOI: 10.1590/s0004-282x2006000300029 -
The Journal of Headache and Pain Aug 2010A 2-year-old female came to the Neurological Emergency Room of "Giovanni XXIII" Hospital in Bari, 6 h after the onset of severe facial pain, which occurred soon after...
A 2-year-old female came to the Neurological Emergency Room of "Giovanni XXIII" Hospital in Bari, 6 h after the onset of severe facial pain, which occurred soon after awakening. Stabbing pain affected the right frontal and periorbital area, with ipsilateral conjunctival injection, swelling of the eyelids and tearing. Except the duration, from 5 to 30 s., the attacks were stereotyped including the occurrence and features of autonomic signs. Based on the typical clinical findings and the normal magnetic resonance imaging (MRI), we diagnosed short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing syndrome (SUNCT). The spontaneous remission within a few hours made prophylactic therapy unnecessary. At the last follow-up, after 3 months, the patient was still symptom free. In our case, after an active period lasting 2 days the disease disappeared completely. However the typical features of the disease (unilateral pain, short duration and high frequency of the attacks, autonomic signs ipsilateral to pain, numbers of attacks) were all present. While the diagnostic criteria of the International Headache Society classification for SUNCT did not include the duration of disease, it is likely that the active period lasting 2 days could be an expression of the clinical variability of the disease.
Topics: Age of Onset; Child, Preschool; Diagnosis, Differential; Female; Humans; Remission, Spontaneous; SUNCT Syndrome; Trigeminal Autonomic Cephalalgias
PubMed: 20473543
DOI: 10.1007/s10194-010-0219-y -
The Journal of International Medical... Oct 2020Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is a rare primary headache syndrome. However, some cases of secondary...
Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is a rare primary headache syndrome. However, some cases of secondary SUNCT are attributed to underlying diseases such as demyelination. We herein report a case of SUNCT with progression to neuromyelitis optica spectrum disorder (NMOSD). A 43-year-old woman developed headaches; 6 weeks later, she developed bilateral visual loss and numbness on the left side of her body. She was ultimately diagnosed with NMOSD.
Topics: Adult; Female; Headache; Humans; Neuralgia; Neuromyelitis Optica; SUNCT Syndrome
PubMed: 33070690
DOI: 10.1177/0300060520964349 -
The Journal of Headache and Pain Jun 2011Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome is a rare headache syndrome classified among the...
Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) secondary to epidermoid cyst in the right cerebellopontine angle successfully treated with surgery.
Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome is a rare headache syndrome classified among the trigeminal autonomic cephalalgias. It is usually idiopathic, although infrequent secondary forms have been described. Recently, the term short-lasting unilateral headache with cranial autonomic symptoms (SUNA) has been defined by the International Headache Society (ICHD-2) as similar to SUNCT with less prominent absent conjunctival injection and lacrimation. We report a patient with paroxysmal orbito-temporal pains, phenotypically suggesting SUNA, secondary to epidermoid cyst in the cerebellopontine angle which disappeared after tumor resection. Neuroimaging should be considered in all patients with SUNA, notably in those with atypical presentation as our patient who presented on examination trigeminal hypoesthesia and tinnitus. Realization of a brain MRI would rule out injuries that causes this type of syndrome.
Topics: Adult; Autonomic Nervous System Diseases; Cerebellopontine Angle; Epidermal Cyst; Female; Humans; Magnetic Resonance Imaging; Neurosurgical Procedures; SUNCT Syndrome
PubMed: 21409598
DOI: 10.1007/s10194-011-0326-4 -
Neurologia (Barcelona, Spain) Sep 2015
Topics: Excitatory Amino Acid Antagonists; Headache; Humans; Lamotrigine; Magnetic Resonance Imaging; Male; Neuralgia; Pituitary Neoplasms; Prolactin; Prolactinoma; Syndrome; Tears; Triazines; Young Adult
PubMed: 24332772
DOI: 10.1016/j.nrl.2013.09.002 -
The Journal of Headache and Pain Apr 2007SUNCT is a rare condition characterised by a short-lasting periorbital pain associated with autonomic symptoms and is usually unresponsive to pharmacological treatment....
SUNCT is a rare condition characterised by a short-lasting periorbital pain associated with autonomic symptoms and is usually unresponsive to pharmacological treatment. We report a case of SUNCT syndrome linked to a pituitary micro-adenoma, with only nocturnal attacks. The nocturnal levels of prolactin (PRL) were increased, while other hormonal, haematological, serological and biochemical investigations and levels of PRL did not reveal abnormal findings during the day-time. PRL serum secretion after thyrotropin-releasing hormone test was lower than nocturnal secretion, but not enough to induce severe attacks. We suggest that in our patient the rise of nocturnal levels of PRL could have a direct role in the worsening of this headache, perhaps secondarily to an altered regulation of the hypothalamic-hypophysial axis, however the actual influence of sleep and the interaction between all neurotransmitters and hormones needs to be clarified further.
Topics: Adult; Brain; Circadian Rhythm; Female; Humans; Magnetic Resonance Imaging; Prolactin; SUNCT Syndrome
PubMed: 17497264
DOI: 10.1007/s10194-007-0370-2 -
The Journal of Headache and Pain Dec 2005Chronic short-lasting headaches, in which trigeminal autonomic cephalalgias (TACs) are included, are relatively rare syndromes and not always well recognised. We present...
Chronic short-lasting headaches, in which trigeminal autonomic cephalalgias (TACs) are included, are relatively rare syndromes and not always well recognised. We present a case highly suggestive of short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) and we try to affirm essential points to distinguish the diagnosis from other TACs and chronic short-lasting headaches. We conclude that the qualifying points for differential diagnosis are number and duration of attacks in a day, presence of autonomic features and lack of indomethacin effect.
Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Conjunctival Diseases; Diagnosis, Differential; Headache; Humans; Indomethacin; Magnetic Resonance Imaging; Male; Syndrome
PubMed: 16388343
DOI: 10.1007/s10194-005-0261-3 -
The National Medical Journal of India 2019A number of treatment options have been used over the years in short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)...
A number of treatment options have been used over the years in short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) with variable results. The most common preventive treatments include carbamazepine, lamotrigine, indomethacin, gabapentin and topiramate. Ketamine is being increasingly used in the treatment of neuropathic pain. The parentral formulations are generally used as oral preparations have poor bioavailability. Recently, ketamine lozenges have been shown to have sufficiently high bioavailability to support their use as a preventive treatment in a number of conditions causing intractable neuropathic pain. We report a 58-year-old man whose symptoms of SUNCT were not responsive to conventional preventive treatments but responded well to a subcutaneous, sub-anaesthetic ketamine infusion and subsequently, sublingual ketamine lozenges.
Topics: Administration, Sublingual; Analgesics, Opioid; Anesthetics, Dissociative; Dose-Response Relationship, Drug; Drug Therapy, Combination; Humans; Infusions, Subcutaneous; Ketamine; Male; Middle Aged; SUNCT Syndrome; Treatment Outcome
PubMed: 31939403
DOI: 10.4103/0970-258X.275347 -
Arquivos de Neuro-psiquiatria Sep 2006To report a case of unilateral headache with two possibilities of diagnosis.
AIM OF THE STUDY
To report a case of unilateral headache with two possibilities of diagnosis.
METHOD
Case report.
RESULTS
Patient with unilateral, intense, stabbing periocular headache with conjuntival injection and tearing. Although the duration of attacks was typical of SUNCT, there was complete remission of the pain with indomethacin, suggesting that this was a case of chronic paroxysmal hemicrania with unusually short attack duration.
CONCLUSION
Therapeutic trials of indomethacin on younger patients presenting clinical diagnosis of SUNCT could be tried on a more regular basis.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Chronic Disease; Diagnosis, Differential; Female; Humans; Indomethacin; Middle Aged; Paroxysmal Hemicrania; SUNCT Syndrome
PubMed: 17119794
DOI: 10.1590/s0004-282x2006000400007 -
The Journal of Headache and Pain Jun 2010The trigeminal autonomic cephalalgias (TACs), including cluster headache, paroxysmal hemicrania and SUNCT, are characterized by the cardinal combination of short-lasting...
The trigeminal autonomic cephalalgias (TACs), including cluster headache, paroxysmal hemicrania and SUNCT, are characterized by the cardinal combination of short-lasting unilateral pain and autonomic phenomena affecting the head. Hemicrania continua (HC) shares many clinical characteristics with TACs, including unilateral pain and ipsilateral autonomic features. Nevertheless, HC is separately classified in the revised International Classification of Headache Disorders (ICHD-II). Here, we describe the case of a 45-year-old man presenting an unusual concurrence of different forms of primary headaches associated with autonomic signs, including subsequently ipsilateral cluster headache, SUNCT and HC. This report supports the theory that common mechanisms could be involved in pathophysiology of different primary headache syndromes.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Anticonvulsants; Autonomic Nervous System; Cerebral Arteries; Cluster Headache; Diagnosis, Differential; Headache; Humans; Male; Middle Aged; SUNCT Syndrome; Treatment Outcome; Trigeminal Autonomic Cephalalgias; Trigeminal Nerve
PubMed: 20376519
DOI: 10.1007/s10194-010-0210-7