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Merck Manual

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Short-Lasting Unilateral Neuralgiform Headache With Conjunctival Injection and Tearing (SUNCT)


Stephen D. Silberstein

, MD, Sidney Kimmel Medical College at Thomas Jefferson University

Last full review/revision May 2020| Content last modified May 2020
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Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), a rare disorder, resembles cluster headaches. It usually causes short but frequent bouts of pain around the eye on one side of the head.

(See also Overview of Headache.)

Because of their similarities, SUNCT and cluster headaches are often grouped together as trigeminal autonomic cephalgias. Trigeminal autonomic cephalgias also include chronic paroxysmal hemicrania, and hemicrania continua—all very rare disorders.

Usually, pain occurs around the eye on one side of the head. People may have up to 200 bouts of pain a day, and the pain may last from 5 seconds to over 4 minutes. The affected eye is red (called conjunctival injection) and frequently waters (tears).

Doctors diagnose SUNCT based on symptoms. Magnetic resonance imaging (MRI) is done to rule out other causes.


  • Lidocaine

  • To prevent attacks, antiseizure drugs or injection of certain drugs

Lidocaine (an anesthetic) is given intravenously to relieve immediate pain.

To prevent attacks, doctors may give people antiseizure drugs (such as lamotrigine, topiramate, or gabapentin) or inject drugs to block or stimulate the nerve that supplies the affected eye (optic nerve).

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