Merck Manual

Please confirm that you are a health care professional

honeypot link

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

By

Stephen D. Silberstein

, MD, Sidney Kimmel Medical College at Thomas Jefferson University

Last full review/revision Aug 2021| Content last modified Aug 2021
Click here for Patient Education

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 Cluster Headache Cluster headaches cause excruciating, unilateral periorbital or temporal pain, with ipsilateral autonomic symptoms (ptosis, lacrimation, rhinorrhea, nasal congestion). Diagnosis is clinical... read more , 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 seconds. Conjunctival injection is often the most prominent autonomic feature; tearing may also be obvious.

Diagnosis of SUNCT

  • Clinical evaluation

Diagnosis of SUNCT is clinical. MRI or CT is done to rule out other possible causes such as a pituitary tumor

  • It has no refractory period.

  • Pain occurs predominantly in the ophthalmic division of the trigeminal nerve.

  • Attacks are not triggered by cutaneous stimuli.

  • Indomethacin does not relieve symptoms, as it does in some other headache disorders.

Treatment of SUNCT

  • For acute attacks, IV lidocaine

  • For prevention, antiseizure drugs and/or occipital nerve stimulation or blockade

Treatment of SUNCT can include IV lidocaine for acute attacks and, for prevention, antiseizure drugs (eg, lamotrigine, topiramate, gabapentin) and occipital nerve stimulation or blockade.

Click here for Patient Education
NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version
Professionals also read
Test your knowledge
Thiamine Deficiency
Thiamin deficiency causes beriberi. It is most common among patients with alcoholism and people subsisting on white rice or highly refined carbohydrates. Early symptoms of all types of beriberi are nonspecific and include fatigue, poor memory, anorexia, and abdominal discomfort. As beriberi progresses, different forms of this condition cause different symptoms. Of these symptoms, which of the following is most indicative of dry beriberi?
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
 

Also of Interest

 
TOP