Clinical profile of SUNCT/SUNA in Japan: A clinic-based study

Abstract

Objectives: This study aimed to report the clinical profiles of patients with short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)/short-lasting unilateral neuralgiform headache attacks with cranial autonomic (SUNA) in a Japanese population by surveying those enrolled at a regional headache center in Japan. Methods:In this consecutive case series study, the clinical characteristics of patients with SUNCT (eight men, three women; mean age: 59.5 + 20.5 years) and SUNA (five men, four women; mean age: 51.3 + 18.4 years) who visited Tominaga Hospital from February 2011 to January 2017 were examined. Headaches were diagnosed according to the International Classification of Headache Disorders, Third edition (ICHD-3) guidelines.Results: Brief clusters of separate attacks were reported by all patients. The mean duration of attacks was 91.9 + 87.9 s. Ipsilateral rhinorrhea was observed in 9 of 20 (45.0%) cases and facial sweating was observed in 1 of 20 (5.0%) cases. An eminent response to lamotrigine was observed in 9 of 9 (100%) patients; however, adverse events were only reported in 2 of 9 (22.2%) cases. An intravenous infusion of lidocaine was demonstrated to be completely successful for short-term prevention in 5 of 6 (83.3%) SUNCT cases.Conclusions: Lamotrigine can successfully treat most patients, and intravenous lidocaine is useful for the short-term preventive therapy of severe recalcitrant attacks in Japanese patients with SUNCT/SUNA.

Cigarette smoking history (personal and secondary childhood exposure) in non-cluster headache trigeminal autonomic cephalalgias: A clinic based study

“…Table 2 lists the smoking exposure history of non-cluster headache TACs that have been previously published in the literature (14–16,23–48). Overall, this is very scant data.…”

“…For SUNCT and SUNA there have been 50 cases with smoking exposure documented histories that have been published (15,32–40). Only 9/50 or 18% had a personal smoking history (one cigar smoker).…”

“…Only 9/50 or 18% had a personal smoking history (one cigar smoker). From the two largest studies which compile 72% of all cases only 5/36 or 14% were cigarette smokers (15) (Table 2). There was only one SUNA positive case while the remainder were diagnosed with SUNCT.…”

“…Most published manuscripts including the largest case series on these conditions lacked any smoking history documentation and no secondary smoke exposure history was noted. For PH the largest number of reported cases in a single study with a documented tobacco exposure history was 74 patients (lacked sex distribution), SUNCT and SUNA 20 patients and for HC a study of 34 patients (no sex distribution was noted) (14)(15)(16). All pediatric and adolescent investigations had no personal or secondary cigarette smoke exposure data (17)(18)(19).…”

Sunct, a Rare Trigeminal Pain

“…Gerakan leher dapat memicu nyeri kepala ini. SUNCT mungkin merupakan bentuk neuralgia trigeminal dan dianggap sebagai salah satu cephalgia otonom trigeminal, atau TAC [14].…”