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SUNCT headaches after ipsilateral ophthalmic-distribution zoster.

Maria A Nagel¹, Ted M Burns², Don Gilden³

¹Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA.

Journal of the Neurological Sciences

|June 12, 2016

Summary

Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) can develop after varicella zoster virus (VZV) reactivation. This case links overt zoster rash to SUNCT, expanding known VZV-associated headache syndromes.

Keywords:

Headaches SUNCT VZV

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Area of Science:

Neurology
Ophthalmology
Infectious Diseases

Background:

Varicella zoster virus (VZV) reactivation can cause various neurological and facial pain syndromes.
Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is a rare headache disorder.
Previous cases have linked SUNCT to VZV meningoencephalitis without a rash.

Observation:

A 47-year-old man presented with SUNCT headaches nine days after developing a left ophthalmic-distribution zoster (shingles) rash.
This presentation involved overt zoster, unlike prior reported cases associated with VZV meningoencephalitis.

Findings:

The case demonstrates a direct association between overt zoster (VZV reactivation with rash) and the development of SUNCT headaches.
This finding expands the spectrum of headache and facial pain syndromes linked to VZV reactivation.

Implications:

Clinicians should consider VZV reactivation as a potential cause of SUNCT, especially in patients with a history of zoster.
This case highlights the diverse neurological manifestations of VZV and emphasizes the importance of recognizing the link between viral reactivation and specific headache types.