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SUNCT syndrome: repetitive and overlapping attacks

J A Pareja1, J Pareja, T Palomo

  • 1Hospital del INSALUD de Llerena, Badajoz, Spain.

Headache
|February 1, 1994
PubMed
Summary

This case study presents a new instance of Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome. The patient experienced severe, brief orbital pain attacks with autonomic symptoms, characteristic of this rare headache disorder.

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Area of Science:

  • Neurology
  • Neuroscience
  • Ophthalmology

Background:

  • Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome is a rare primary headache disorder.
  • It is characterized by severe, unilateral orbital, supraorbital, or temporal pain lasting seconds to minutes.
  • Autonomic symptoms such as conjunctival injection, lacrimation, nasal congestion, rhinorrhea, and eyelid edema are typically present.

Observation:

  • A 79-year-old male presented with a two-year history of right orbital pain attacks.
  • The pain was described as electrical or burning, lasting 30-60 seconds, and accompanied by ipsilateral conjunctival injection, tearing, and mild rhinorrhea.
  • Attacks occurred 2-3 times daily, with periods of increased frequency up to continuous short-lasting episodes lasting 1-3 hours.

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Findings:

  • The patient's clinical presentation, including the character, duration, and frequency of pain attacks, along with prominent autonomic features, strongly suggests a diagnosis of SUNCT syndrome.
  • The attacks were triggered by stimuli affecting trigeminal and extra-trigeminal innervated areas.
  • The irregular temporal pattern with spontaneous remissions and unpredictable symptomatic phases is consistent with the natural history of SUNCT syndrome.

Implications:

  • This case adds to the literature on SUNCT syndrome, highlighting its occurrence in an elderly patient.
  • Understanding the triggers and clinical course is crucial for accurate diagnosis and management of SUNCT syndrome.
  • Further research into the pathophysiology of SUNCT syndrome may lead to improved therapeutic strategies for patients suffering from this debilitating condition.