SUNCT syndrome: repetitive and overlapping attacks

A 79-year-old patient had been suffering from right orbital pain attacks since he was 77. The pain, of an "electrical" or burning character, was moderate to severe in intensity. Single attacks lasted for 30-60 seconds each and were accompanied by prominent ipsilateral conjunctival injection and tearing as well as slight rhinorrhoea. The temporal pattern of attacks was irregular with spontaneous remissions alternating with unpredictable symptomatic phases. During active periods, attacks could be triggered by several precipitants acting on trigeminal and extra-trigeminal innervated areas. On most occasions, the patient had 2-3 attacks daily but, at worst, he might have almost continuous short-lasting attacks in periods of 1 to 3 hours length. When attacks had such frequency they presented either as repetitive or overlapping single episodes. According to the clinical features it is concluded that the case reported is a new case of SUNCT syndrome.