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SUNCT syndrome responsive to gabapentin (Neurontin)
1The Pain Center of Cedars-Sinai Medical Center and UCLA School of Dentistry, Los Angeles, CA, USA.
Cephalalgia : an International Journal of Headache
|October 19, 2000
Summary
Gabapentin effectively managed severe unilateral neuralgiform headache with conjunctival injection and tearing, rhinorrhea and sub-clinical sweating (SUNCT) in a patient with a decade of treatment resistance. This case highlights gabapentin
Area of Science:
- Neurology
- Headache Medicine
Background:
- Severe unilateral neuralgiform headache with conjunctival injection and tearing, rhinorrhea and sub-clinical sweating (SUNCT) is a rare headache disorder.
- Patients often experience debilitating pain and multiple failed treatment attempts.
Observation:
- A 48-year-old male with a 10-year history of SUNCT presented with severe, strictly left-sided ocular, facial, and temple pain.
- Pain attacks were frequent (25/day), short-lived (2-3 min), and characterized by burning, sharp, shooting sensations with autonomic symptoms like tearing and conjunctival injection.
- Previous treatments, including indomethacin, were ineffective.
Findings:
- Gabapentin at 1800 mg/day initially provided improvement.
- Upon restarting gabapentin at 900 mg three times daily after a period of non-adherence, the patient achieved 12 months of complete pain relief.
- This suggests a significant therapeutic response to gabapentin in this SUNCT case.
Implications:
- Gabapentin may be a viable treatment option for refractory SUNCT syndrome.
- This case underscores the importance of consistent medication adherence for managing chronic headache disorders.
- Further research into gabapentin's efficacy for SUNCT is warranted.
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