Headache

SUNCT Syndrome

SUNCT Syndrome, SUNCT Headache, Short-Lasting Unilateral Neuralgiform Headache Attacks with Conjunctival Injection or Tearing, SUNA Headache, Short-Lasting Unilateral Neuralgiform Headache Attacks with Cranial Autonomic Symptoms

See Also

Classification

Short duration
Trigeminal Autonomic Cephalgia
1. Headaches similar to Cluster Headache
2. Unilateral trigeminal distribution symptoms with autonomic features

Symptoms

Region
1. Unilateral orbital, supraorbital or temporal Headache
Characteristics
1. Stabbing or pulsating pain
Timing
1. Duration <4 minutes per episode
2. Recurrs for 3-200 attacks/day
Associated Symptoms (autonomic findings)
1. Ipsilateral Conjunctival injection
2. Ipsilateral Lacrimation

Diagnosis

Characteristics: At least 20 or more Headaches meeting the following criteria
1. Severe to very severe unilateral orbital, supraorbital or temporal pain lasting seconds to 10 minutes
  1. Occurs as single stab or multiple stabs
2. Headaches at least once daily
3. At least 2 Headaches last 7 days to 1 year (when untreated)
4. Headache with at least one of the following ipsilateral autonomic symptoms
  1. Conjunctival injection or Lacrimation
  2. Nasal congestion or Rhinorrhea
  3. Eyelid Edema
  4. Forehead and facial sweating
  5. Miosis or Ptosis
Timing
1. Episodic
  1. Headaches with pain-free periods >3 month
2. Chronic
  1. Episodes recur for more than 1 year without remission or with remission <3 month
References
1. (2018) Cephalgia 38(1):1-211 [PubMed]

Differential Diagnosis

See Cluster Headache

Management

No established definitive management
See Cluster Headache for potential management options

References