SUNCT syndrome

SUNCT syndrome
Synonyms	Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing
Pronounce	N/A
Specialty	N/A
Symptoms	Headache, conjunctival injection, lacrimation
Complications	N/A
Onset	Typically in adulthood
Duration	Attacks last 5 to 240 seconds
Types	N/A
Causes	Unknown
Risks	Possible genetic predisposition
Diagnosis	Clinical evaluation, exclusion of other conditions
Differential diagnosis	Cluster headache, trigeminal neuralgia
Prevention	N/A
Treatment	Lamotrigine, gabapentin, topiramate
Medication	Anticonvulsants, local anesthetics
Prognosis	Variable, often chronic
Frequency	Rare
Deaths	Not directly life-threatening

SUNCT syndrome is a rare primary headache disorder that belongs to the group of Trigeminal autonomic cephalalgias (TACs). The acronym stands for Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing. It is characterized by extremely frequent bursts of severe, unilateral head pain, and autonomic features such as red and tearing eyes and a blocked or runny nose.

Symptoms

The primary symptom of SUNCT syndrome is a sudden, severe, sharp, stabbing, or burning pain that is usually on one side of the head. The pain typically occurs in the orbital, supraorbital, or temporal area and lasts from 5 to 240 seconds. The attacks of pain occur more than 20 times a day and are associated with redness and tearing of the eyes, a blocked or runny nose, and swelling of the eyelid on the affected side.

Causes

The exact cause of SUNCT syndrome is unknown. However, it is thought to involve the hypothalamus, as this area of the brain has been shown to be active during attacks. Some cases have been associated with abnormalities in the posterior fossa, such as arteriovenous malformations and tumors.

Diagnosis

Diagnosis of SUNCT syndrome is based on the patient's symptoms and the exclusion of other conditions. A detailed medical history and physical examination are essential. Neuroimaging, such as an MRI, may be used to rule out other causes of the symptoms.

Treatment

Treatment of SUNCT syndrome is challenging due to the frequency and severity of the attacks. Medications such as lamotrigine and gabapentin have been found to be effective in some cases. In refractory cases, surgical procedures such as microvascular decompression or hypothalamic deep brain stimulation may be considered.

See also

• Trigeminal autonomic cephalalgias
• Cluster headache
• Paroxysmal hemicrania

References

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