SUNCT/SUNA: A Review

Pomeroy, Jared L.; Nahas, Stephanie J.

doi:10.1007/s11916-015-0511-2

Cited by 18 publications

(28 citation statements)

References 35 publications

(49 reference statements)

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“…Recent studies have reported satisfactory results using antiepileptic drugs; currently, the first-line agent is lamotrigine, whereas the second-line drugs include gabapentin and topiramate. [4,5] For severe and treatment-resistant patients, there are pioneer studies on deep brain stimulation and microvascular surgery. [6][7][8][9] Some authors have reported conflicting results regarding the efficacy of great occipital nerve (GON) block.…”

Section: Discussionmentioning

confidence: 99%

Peripheral nerve blocks in the treatment of short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) during pregnancy

Yalın¹

2017

Agri

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ÖzetKonjunktival injeksiyon ve göz yaşarması ile birlikte kısa-süreli unilateral nevraljifrm başağrısı atakları (SUNCT), trigeminal otonomik başağrıları içerisinde sınıflandırılan nadir gözlenen bir primer başağrısı bozukluğudur. SUNCT genellikle tedaviye dirençli bir sendrom olarak kabul edilmesine rağmen son yıllarda antiepileptik ilaçlar ile anlamlı düzelme bildirilmektedir. Hastalığın gebelikteki seyri ve tedavisi ile ilgili literatürde bilgi yoktur. Bu çalışmada 30 haftalık gebelik sırasında SUNCT atağı yaşayan, infra-ve supraorbital sinir blokajı ile başarılı bir şekilde tedavi edilen bir olgu sunulmaktadır. Aslında gebelik döne-minde lamotrijin kısmen güvenli olarak kullanılmaktadır, fakat periferal sinir blokajı uygulanması pratik, güvenli ve etkin bir alternatif tedavi seçeneğidir. Bu olgu literatürde gebelik döneminde infra-ve supraorbital sinir blokajı ile başarılı bir şekilde tedavi edilen ilk SUNCT hastasıdır.Anahtar sözcükler: Infraorbital; sinir blokajı; SUNCT; supraorbital. SummaryShort-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare, primary headache syndrome, which is classified as a subtype of trigeminal autonomic cephalalgias. Although SUNCT is usually refractory to treatment, several antiepileptic drugs have recently shown promising results for its treatment. However, there is a lack of evidence regarding the course of SUNCT during pregnancy and the available treatment options. Here, we present a 30-week pregnant female with SUNCT who was successfully treated with infra-and supraorbital nerve blocks. Headache attacks completely diminished after the injection, and recurrence was not observed. Although lamotrigine may be relatively safe in pregnant patients with SUNCT attacks, peripheral nerve block may be a feasible technique and can be considered as a safe and effective treatment option. This is the first SUNCT case in the literature that was successfully treated with infra-and supraorbital nerve blocks during pregnancy.

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Section: Discussionmentioning

confidence: 99%

Peripheral nerve blocks in the treatment of short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) during pregnancy

Yalın¹

2017

Agri

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“…In addition there are positive reports on topiramate, carbamazepine, gabapanetin, botulinum toxin, and nerve blocks, which seemed to be effective in some patients . Invasive procedures used in patients refractory to pharmacological treatment include microvascular decompression, deep brain stimulation, and occipital nerve stimulation . In two small case series, microvascular decompression rendered seven of 12 patients pain‐free.…”

Section: Sunct/sunamentioning

confidence: 99%

“…In two small case series, microvascular decompression rendered seven of 12 patients pain‐free. Apart from lack of efficacy, the procedure may cause serious adverse effects such as hearing loss and dysequlibrium . In 11 patients, deep brain stimulation of the ventral tegmental area showed a 50% improvement in daily attack frequency in 82% of the patients and a reduction in headache load by 99%.…”

Section: Sunct/sunamentioning

confidence: 99%

“…The system had to be removed in one patient because of wound infection, otherwise there were no serious adverse events . Nevertheless, it is essential to weigh a potential benefit against the risk of serious complications . Occipital nerve stimulation showed improvement by more than 90% in eight of nine patients .…”

Section: Sunct/sunamentioning

confidence: 99%

“…Occipital nerve stimulation showed improvement by more than 90% in eight of nine patients . Adverse events include lead migration and infection …”

Section: Sunct/sunamentioning

confidence: 99%

See 2 more Smart Citations

Tics in TACs: A Step into an Avalanche? Systematic Literature Review and Conclusions

Wöber

2017

Headache

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TACs are related to tics in various ways. TN or TN-like paroxysms may co-occur with CH, PH, and HC, labeled as cluster-tic syndrome, PH-tic syndrome, and HC-tic syndrome. Such co-occurrence was not only found in the primary TACs but also in secondary headaches resembling TACs. The initial onset of TAC and tic may be simultaneous or separated by months or years. In acute attacks, tic and TAC may occur concurrently or much more often independently of each other. The term "cluster-tic syndrome" was also used in patients with a single type of pain in a twilight zone between TACs and TN fulfilling none of the relevant diagnostic criteria. Short-lasting neuralgiform headache attacks overlap with TN in terms of clinical features, imaging findings, and therapy.

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Epicrania Fugax

Cuadrado

Peral

Pareja

2016

Curr Pain Headache Rep

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Epicrania fugax (EF) is a primary headache of recent description. EF essentially consists of brief paroxysms of pain describing a linear or zigzag trajectory across the surface of one hemicranium, commencing and terminating in the territories of different nerves. The pain of forward EF originates in a particular area of the occipital, parietal or temporal regions and moves anteriorly, whereas the pain of backward EF originates in the frontal area, the eye or the nose and moves posteriorly. Some patients have ocular or nasal autonomic accompaniments, and some have triggers. Between attacks, many patients have continuous or intermittent pain and/or tenderness at the stemming area. Pain frequency is extremely variable and some patients have spontaneous remissions. Preventive therapy is required when the paroxysms are frequent and non-remitting. Neuromodulators, indomethacin, amitryptiline, nerve anesthetic blockades, and trochlear steroid injections have been used in different cases, with partial or complete response.

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SUNCT/SUNA: A Review

Cited by 18 publications

References 35 publications

Peripheral nerve blocks in the treatment of short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) during pregnancy

Peripheral nerve blocks in the treatment of short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) during pregnancy

Tics in TACs: A Step into an Avalanche? Systematic Literature Review and Conclusions

Epicrania Fugax

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