Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is a rare headache disorder characterized by extremely frequent attacks of unilateral head pain and autonomic activation.
SUNCT, like cluster headache, is a primary headache disorder characterized by unilateral pain in the trigeminal nerve distribution and by autonomic manifestations. As such, SUNCT and cluster headaches are sometimes grouped together as trigeminal autonomic cephalgias.
In SUNCT, pain paroxysms are typically periorbital, are extremely frequent (up to 200/day), and last from 5 to 250 sec. Conjunctival injection is often the most prominent autonomic feature; tearing may also be obvious.
Diagnosis is clinical. SUNCT should be distinguished from trigeminal neuralgia, which causes similar symptoms; SUNCT differs in that
Treatment can include IV lidocaine for acute attacks and, for prevention, anticonvulsants (eg, lamotrigine, topiramate, gabapentin) and occipital nerve stimulation or blockade.
Last full review/revision April 2014 by Stephen D. Silberstein, MD
Content last modified April 2014