A Retrospective Comparative Study in Patients with SUNA and SUNCT

Area of Science:

• Neurology
• Headache Medicine
• Clinical Research

Background:

• Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are rare primary headache disorders.
• Understanding their distinct or overlapping clinical characteristics is crucial for accurate diagnosis and management.

Purpose of the Study:

• To describe and compare the clinical characteristics of patients diagnosed with SUNA and SUNCT.
• To identify any significant differences or similarities between these two headache types.

Main Methods:

• A retrospective evaluation of patients diagnosed with SUNCT or SUNA.
• Data collected from patients seen at a tertiary hospital neurology clinic in India between January 2017 and December 2022.
• Analysis of demographic and clinical features, including pain characteristics, autonomic symptoms, triggers, and refractory periods.

Main Results:

• The study included 13 SUNA patients and 16 SUNCT patients, with comparable mean ages at onset (around 37 years).
• Orbital/retro-orbital pain was most common in both groups. Pain patterns included single stabs, repetitive stabs, and sawtooth patterns, with most attacks lasting under two minutes.
• Conjunctival injection and tearing were present in all SUNCT patients and in a significant proportion of SUNA patients (46% and 31%, respectively). Triggers were reported in over half of patients in both groups.

Conclusions:

• This case series, the largest from India, found no significant differences in demographic or clinical features between patients with SUNA and SUNCT.
• The findings suggest a potential overlap and similarity between these two rare headache disorders.
• Further research may be warranted to elucidate the precise relationship and potential unified classification.