“SUNCT” Syndrome. A Case of Transformation from Trigeminal Neuralgia?

Bouhassira, Didier; Attal, Nadine; Estève, M.; Chauvin, M.

doi:10.1046/j.1468-2982.1994.1402168.x

Cited by 69 publications

(61 citation statements)

References 4 publications

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“…The tendency to attacks of CH is in most cases abated by prednisone, verapamil, lithium, ergotamine, subcutaneously administered sumatriptan or 100% oxygen; SUNCT syndrome is generally refractory to drug therapy of any kind or anesthetic blockades. From our own data [67] and many other reports [11,23,25,27,[68][69][70][71][72][73][74], more than 20 SUNCT patients have received many different kinds of treatments and only solitary cases have been reported with a good response to individual drugs. For practical reasons, not all drugs can be tried in every patient.…”

Section: Clinical Variablesmentioning

confidence: 89%

“…Since ipsilateral, autonomic phenomena are obligatory for the diagnosis of SUNCT [3], they have been present in all described cases [1,2,5,11,13,[22][23][24][25][26][27][28][29]. It seems that ipsilateral lacrimation and conjunctival injection are the most common features accompanying SUNCT attacks, but rhinorrhea/nasal stenosis are also quite common [7].…”

Section: Clinical Variablesmentioning

confidence: 99%

“…Mechanical precipitation of attacks, although not entirely obligatory, is quite typical for SUNCT [1,2,11,13,22,[24][25][26]28]. Eighteen out of 21 patients described a variety of precipitating mechanisms [12].…”

Section: Clinical Variablesmentioning

confidence: 99%

“…Parenterally administered ergotamine and intravenously given dihydroergotamine have also been used to treat attacks of CH. Of 9 reported SUNCT patients [11,25,67,70] receiving these drugs, only one had a partial effect [25]. Sumatriptan has been tested in some patients: orally (100-300 mg/day) in 3 patients [67] and in a single subcutaneous dose [11,70,74].…”

Section: Clinical Variablesmentioning

confidence: 99%

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Cluster headache and SUNCT: similarities and differences

Kruszewski

Pareja

Caminero³

et al. 2001

J Headache Pain

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IntroductionOur first case of SUNCT was found in 1978 [1], and a total of three cases were later published under the common name "shortlasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing" in 1989 [2]. Currently, SUNCT is defined by the International Association for the Study of Pain (IASP) as "Repetitive paroxysms of unilateral shortlasting pain, usually 15-120 seconds duration, mainly in the ocular and the periocular areas, of a neuralgiform nature and moderate to severe intensity, usually appearing only during daytime and accompanied by ipsilateral marked conjunctival injection, lacrimation, a low to moderate degree of rhinorrhea, and subclinical forehead sweating", and belongs to the group of neuralgias of the head and face [3]. Furthermore, the pain paroxysms accompanied by autonomic phenomena tend to appear in cluster periods, and there is a clear male preponderance in SUNCT [3]. Thus, SUNCT has even been considered to be in the same group as cluster headache (CH) [4,5]. Abstract SUNCT is probably a distinct syndrome, although it shares some common features with cluster headache (CH): male sex preponderance, clustering of attacks, unilaterality of headache without sideshift, pain of non-pulsating type with its maximum in the periocular area, ipsilateral autonomic phenomena (e.g. conjunctival injection, lacrimation, rhinorrhea, increased forehead sweating), systemic blood pressure increment with heart rate decrement, blood flow velocity decrement in the middle cerebral artery, and hyperventilation. In spite of these similarities, SUNCT syndrome differs clearly from CH as regards a number of clinical variables, such as duration, intensity, frequency, and nocturnal preponderance of attacks. The two syndromes also differ markedly as regards precipitation of attacks, the usual age at onset, and efficacy of various treatment alternatives.Laboratory investigations have disclosed differences as regards presence or absence of Horner-like picture and possibly also the respiratory sinus arrhythmia pattern. All in all, these differences seem sufficiently ponderous to make it likely that SUNCT syndrome and CH differ essentially. SUNCT seems to be a "neuralgiform" headache, but different from trigeminal neuralgia.

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Section: Clinical Variablesmentioning

confidence: 89%

Section: Clinical Variablesmentioning

confidence: 99%

Section: Clinical Variablesmentioning

confidence: 99%

Section: Clinical Variablesmentioning

confidence: 99%

See 2 more Smart Citations

Cluster headache and SUNCT: similarities and differences

Kruszewski

Pareja

Caminero³

et al. 2001

J Headache Pain

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“…É interessante salientar que existem descrições de neuralgia trigeminal que evoluiu para SUNCT 28 ou que nos períodos de dor mais intensa, apresentava-se fenotipicamente como SUNCT 29 .…”

Section: Discussionunclassified

Uso de gabapentina no tratamento da Síndrome SUNCT

Rocha-Filho

Rabello

Galvão

et al. 2007

Arq. Neuro-Psiquiatr.

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A síndrome SUNCT (short-lasting unilateral neuralgiform headache attacks with conjuntival injection and tearing) foi descrita pela primeira vez por Sjaastad e colaboradores em 1989 1 , só recentemente sendo incluída na segunda edição da Classificação Internacional de Cefaléias no grupo que inclui a cefaléia em salvas e outras cefaléias trigêmino-autonômicas 2 . Esta cefaléia é caracterizada por dor unilateral, orbitária, supra-orbitária ou temporal, em pontada ou pulsátil, com duração de 5-240 segundos, associada a hiperemia conjuntival e lacrimejamento ipsilaterais a mesma 2 . Os sintomas autonômicos, em geral dramáticos, iniciam-se rapidamente após o início da dor, podendo haver além dos já citados, rinorréia e obstrução nasal 1,3,4 . As crises podem ter freqüência variável, de uma a duas crises por dia a até 10-30 crises por hora, de ocorrência geralmente diurna 5 , podendo ser precipitada por manobras mecânicas do pescoço e por zonas gatilho em topografias trigeminais e extra-trigeminais, geralmente não se observando períodos refratários após estímulos sucessivos 1,4,6 . Esta síndrome inicia-se geralmente entre os 41 e 70 anos (média de 51 anos) 4 e tem uma predominân-cia do sexo masculino 4,5 . As crises têm padrão irregular, com alternância errática entre períodos com dor, que variam de dias a meses e geralmente ocorrem 1 a 2 vezes por ano, e períodos de remissão que podem durar meses 4 . Dentre as cefaléias primárias, temos como diagnósticos diferenciais a hemicrânia paroxística crônica, a cefaléia em salvas, a neuralgia do primeiro ramo do trigêmio e a cefaléia idiopática em facadas 7 . Apesar RESUmO -Relatamos o caso clínico de duas mulheres com quadro compatível com síndrome SUNCT (cefaléia de curta duração, unilateral, neuralgiforme com hiperemia conjuntival e lacrimejamento). As duas apresentavam exames clínico e neurológico normais e Rm com sinais de microangiopatia. A primeira apresentava cefaléia há três anos, que ocorria várias vezes por dia, sempre que mastigava ou bocejava. Havia feito uso várias medicações sem melhora. A dor foi controlada após o uso de 600 mg de gabapentina ao dia. A segunda paciente referia cefaléia há seis meses. A dor era diária, ocorrendo de 20-40 vezes por dia. Na ocasião da primeira avaliação no ambulatório, já fazia uso 600 mg de carbamazepina ao dia e 15 mg de clorpromazina, com melhora parcial. Após introdução de gabapentina-1200 mg/ dia, a paciente evoluiu sem dor, porém com episódios de hiperemia conjuntival.PAlAvRAS-CHAvE: SUNCT, cefaléia, tratamento, gabapentina, dor, cefaléia ultra-curta.gabapentin in the treatment of sUnCt syndromeAbSTRACT -We report the cases of two women who presented a clinical condition compatible with the SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) syndrome. both presented normal clinical and neurological examination and mRI compatible with microangiopathy. The first one related headache attacks for three years, occurring several times a day when she masticated or yawned. She had a...

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Kopf- und Gesichtsneuralgien, Schmerz bei Affektion von Nervenstämmen und Deafferenzierungsschmerzen

Göbel

1997

Die Kopfschmerzen

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“SUNCT” Syndrome. A Case of Transformation from Trigeminal Neuralgia?

Cited by 69 publications

References 4 publications

Cluster headache and SUNCT: similarities and differences

Cluster headache and SUNCT: similarities and differences

Uso de gabapentina no tratamento da Síndrome SUNCT

Kopf- und Gesichtsneuralgien, Schmerz bei Affektion von Nervenstämmen und Deafferenzierungsschmerzen

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