SUNCT syndrome: VIII. Pupillary reaction and corneal sensitivity

SUNCT is a newly described headache characterized by shortlasting, unilateral attacks of a neuralgiform character, accompanied by conjunctival injection and tearing on the symptomatic side. At present, 8 patients have been observed, all males. In the present work, vertical pupillary diameters have been estimated by the binocular, Whittaker infrared pupillometer (Gulf & Western). Measurements have been carried out both during the basal state and after topical, pharmacologic stimulation (by sympathicomimetic agents, i.e. tyramine (2%), OH-amphetamine (1%) and phenylephrine (1%). In the basal state, there was no clear tendency to anisocoria. After sympathicomimetic drugs, there was a tendency to underreaction on the symptomatic side, mainly as regards the indirectly acting ones (OH-amphetamine and tyramine). These two agents should supposedly give similar results, but, nevertheless, the results partly deviated. Phenylephrine did not invariably normalize the symptomatic/non-symptomatic side ratio. Corneal sensitivity was investigated with the Cochet-Bonnet esthesiometer. Two of 6 patients studied outside attack showed moderately lowered values on the symptomatic side. During attack, there seemed to be reduced corneal sensitivity in both patients investigated, in one bilaterally, in the other, on the symptomatic side only.