Aim: Little is known about short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA). We present our experience with SUNCT/SUNA patients to aid identification and management of these disorders. Methods: A retrospective review of patient records of one orofacial pain clinic was performed. Inclusion criteria was a diagnosis of SUNCT/SUNA confirmed with at least one follow-up visit. Results: Six of the 2464 new patients seen between 2015–2018 met the selection criteria (SUNCT n = 2, SUNA n = 4). Gender distribution was one male to one female and average age of diagnosis was 52 years (range 26–62). Attacks were located in the V1/V2 trigeminal distributions, and five patients reported associated intraoral pain. Pain quality was sharp, shooting, and burning with two patients reporting “numbness”. Pain was moderate-severe in intensity, with daily episodes that typically lasted for seconds. Common autonomic features were lacrimation, conjunctival injection, rhinorrhea, and flushing. Frequent triggers were touching the nose or a specific intraoral area. Lamotrigine and gabapentin were commonly used as initial therapy. Conclusions: Differentiating between SUNCT/SUNA does not appear to be clinically relevant. Presenting symptoms were consistent with those published, except 5/6 patients describing intraoral pain and two patients describing paresthesia.
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© International Headache Society 2020.
- Trigeminal autonomic cephalalgias (TAC)
- short-lasting unilateral neuralgiform facial attacks with autonomic signs (SUNFA)
- short-lasting unilateral neuralgiform headache attacks (SUNHA)
- short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)
- short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA)
- temporomandibular disorders