SUNCT syndrome treated with gamma knife targeting the trigeminal nerve and sphenopalatine ganglion

Botulinum Toxin A for the Treatment of a Child with SUNCT Syndrome

“…Three patients with SUNCT have reported complete relief from symptoms after glycerol ablation, lasting from several weeks to 4 years [ 16 ]. Of the two cases treated with gamma knife ablation of the trigeminal and sphenopalatine ganglia, one achieved complete pain relief for 39 months without the need for analgesics [ 17 ], while the other had intermittent symptoms during 4 months of initial follow-up [ 18 ]. One of the two patients treated with gamma knife ablation of the trigeminal ganglion reported improved pain relief for 2 months and the other experienced no benefit [ 19 ], while the two patients who underwent radiofrequency thermocoagulation of the trigeminal ganglia experienced 2 and 3 years of pain relief [ 20 , 21 ].…”

Gamma Knife Radiosurgery for Short Unilateral Neuralgiform Headache Attacks with Conjunctival Injection and Tearing (SUNCT) Syndrome: Targeting the Trigeminal Nerve and the Sphenopalatine Ganglion. Case Report and Literature Review

“…Radiosurgical treatment was effective in 4 of 6 patients (this study). [11][12][13] The 2 cases reported by Black et al 10 did not show any significant improvement after radiosurgery treatment. The authors did not give any explanation for the failures; however, in both cases, only the entry root of the trigeminal nerve was irradiated, without targeting the sphenopalatine ganglion.…”

“…According to our review, only 5 patients with SUNCT treated with radiosurgery have been reported up to now. [10][11][12][13] In 2002, Black and Dodick reported the first 2 SUNCT patients treated with radiosurgery. 10 Both patients had failed medical therapies.…”

“…Subsequent reports of idiopathic SUNCT cases documented that radiosurgery treatment was beneficial. [11][12][13] Effendi et al reported a case in 2011 of SUNCT successfully treated by GKRS with irradiation of both the trigeminal nerve and sphenopalatine ganglion. A dose of 80 Gy was delivered to both structures.…”

“…A 50year-old man with SUNCT refractory to medications received GKRS treatment. 12 He was given 80 Gy both to the trigeminal nerve and the sphenopalatine ganglion. At 4 months' follow-up, he had no more spontaneous attacks and only very occasional brief episodes of pain, precipitated by touching.…”