Gabapentin in the Treatment of SUNCT Syndrome

Porta‐Etessam, J.; Benito‐León, Julián; Martínez-Salio, A; Berbel, A

doi:10.1046/j.1526-4610.2002.02128.x

Cited by 51 publications

(30 citation statements)

References 7 publications

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“…Gabapentin has been tried in nine patients with SUNCT syndrome. It was highly effective in three patients, completely suppressing the attacks when administered at 800 to 2700 mg daily [6,22,51]. However, it has been reported to be completely ineffective in six patients [11,12,16,23,25].…”

Section: Anticonvulsantsmentioning

confidence: 96%

See 1 more Smart Citation

Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing syndrome: a review

Matharu¹,

Cohen²,

Boes³

et al. 2003

Current Science Inc

110

114

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The clinical features of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome have been reviewed in 50 patients reported in the English language literature. SUNCT syndrome is a rare condition that predominates slightly in men. The mean age at onset is 50 years. It is characterized by strictly unilateral attacks centered on the orbital or periorbital regions, forehead, and temple. Generally, the pain is severe and neuralgic in character. The usual duration ranges from 5 to 250 seconds, although the reported range of duration is 2 seconds to 20 minutes. Ipsilateral conjunctival injection and lacrimation are present in most, but not all patients. Most patients are thought to have no refractory periods and this has probably been unreported in the past. Episodic and chronic forms of SUNCT exist. The attack frequency varies from less than one attack daily to more than 60 attacks per hour. The attacks are predominantly diurnal, although frequent nocturnal attacks can occur in some patients. A functional magnetic resonance imaging study in SUNCT syndrome has demonstrated ipsilateral hypothalamic activation. SUNCT was thought to be highly refractory to treatment. However, recent open-label trials of lamotrigine, gabapentin, topiramate, and intravenous lidocaine have produced beneficial therapeutic responses. These results offer the promise of better treatments for this syndrome, but require validation in controlled trials.

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Section: Anticonvulsantsmentioning

confidence: 96%

“…There is one case report that states that selective serotonin reuptake inhibitors were administered without any beneficial response in a patient, although the agents used were not stated [51].…”

Section: Tricyclic Antidepressantsmentioning

confidence: 99%

Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing syndrome: a review

Matharu¹,

Cohen²,

Boes³

et al. 2003

Current Science Inc

110

114

View full text Add to dashboard Cite

show abstract

“…SUNCT has been shown to respond to gabapentin, with complete suppression of attacks in three of nine patients treated with 800-2,700 mg daily [12][13][14]. When tried in an open-label fashion in 22 SUNCT and 5 SUNA patients at up to 3,600 mg daily, it was reported to be effective in 60 % of SUNA but only 45 % of SUNCT patients [6].…”

Section: Gabapentinmentioning

confidence: 99%

SUNCT and SUNA: medical and surgical treatments

Lambru

Matharu

2013

Neurol Sci

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Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are rare and often disabling primary headache disorders. Their management can be challenging. The abortive therapies are not generally useful as the attacks are relatively short lasting. A myriad of pharmacological preventive treatments have been tried in single case reports or small series in an openlabel fashion. Lamotrigine, as an oral preventive treatment, and lidocaine, as an intravenous transitional treatment, seem to be the most effective therapies. For medically intractable chronic forms of SUNCT and SUNA, several surgical approaches have been tried. These include ablative procedures involving the trigeminal nerve or the Gasserian ganglion, microvascular decompression of the trigeminal nerve, and neurostimulation techniques. This review provides an overview of the current pharmacological and surgical options for SUNCT and SUNA syndromes.

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“…Rare cases are responsive to gabapentin [23][24][25] , topiramate 26 , carbamazepine 4 , corticosteroids, or surgical procedures 27 . Some cases did not improve after surgical treatment, and there was significant morbidity 28 .…”

Section: Discussionmentioning

confidence: 99%

Influence of lamotrigine over the sunct syndrome: one patient follow-up for two years

Piovesan

Siow

Kowacs

et al. 2003

Arq. Neuro-Psiquiatr.

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-The SUNCT syndrome is characterized by a short-lasting headache in the first division of the trigeminal nerve, associated with ipsilateral autonomic symptoms. It is highly refractory to prophylactic medication. We describe a case where lamotrigine reduced the intensity, duration, and frequency of attacks and increased the remission period of this disorder. Over a two-year period, the attacks came back immediately whenever the patient reduced the dose or neglected treatment. We concluded that lamotrigine is effective in treating SUNCT syndrome when used in high doses for a prolonged period of time.KEY WORDS: lamotrigine, prophylactic treatment, SUNCT syndrome, trigeminal autonomic cephalalgia.Influência da lamotrigina sobre a síndrome SUNCT: comportamento de um paciente durante período de dois anos RESUMO -A sindrome SUNCT caracteriza-se por cefaléia de curta duração localizada na primeira divisão do nervo trigêmio e associada com sintomas autonômicos ipsilaterais. A resposta clínica aos diversos tratamentos profiláticos propostos têm sido caracterizados pela alta refratoriedade. Nós descrevemos um caso em que a lamotrigina reduziu a intensidade, duração e frequência dos ataques, aumentando o período de remissão. Por um período de dois anos em que utilizamos a lamotrigina, surgiram novos ataques quando o paciente reduziu a dose ou negligenciou o seu tratamento.Concluímos que lamotrigina é tratamento eficaz para a síndrome SUNCT quando utilizada em altas doses e por período prolongado de tempo. PALAVRAS-CHAVE: cefaléias trigemino-autonomicas, lamotrigina, SUNCT sindrome, tratamento profilático. Dr. Elcio Juliato Piovesan -Rua Jorge Manços do Nascimento Teixeira 868 -83005-500 São José dos Pinhais PR -Brasil.Shortlasting, unilateral, neuralgiform headache with conjunctival injection and tearing (SUNCT syndrome) was first described by Sjaastad 25 years ago 1 . During this period, some new clinical evidences were included in the spectrum of this syndrome, but our knowledge of this disorder is constantly advancing.We describe a case responsive to lamotrigine and review the current literature on SUNCT. CASEA 45-year-old man had a five-year history of severe shooting pain over the left eye that lasted 30 seconds and occured as often as 20 times a day. These symptoms were accompanied by intense ipsilateral tearing, conjunctival injection, and nasal congestion. Attacks could be provoked by touching the left temporal region, putting his foot on the ground, eating, or moving his neck. General physical and neurologic examinations, routine blood analysis, and CT and MRI of the brain were normal. The patient tried indomethacin 200mg/day, verapamil 480mg/day, carbamazepine 1200mg/day, phenytoin 300mg/day, valproate 1000mg/day, and greater occipital and supraorbital blocker with bupivacaine and steroids, all without effect. During the attacks, he used oxygen and triptans but had poor results. The patient also had thermocoagulation of the ipsilateral trigeminal ganglion performed. He had a good result and was symptom-f...

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Gabapentin in the Treatment of SUNCT Syndrome

Cited by 51 publications

References 7 publications

Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing syndrome: a review

Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing syndrome: a review

SUNCT and SUNA: medical and surgical treatments

Influence of lamotrigine over the sunct syndrome: one patient follow-up for two years

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