Headache in SUNCT

What is SUNCT?

SUNCT stands for Short Lasting Unilateral Neuralgiform Headache Attacks with Conjunctival Injection and Tearing and is also characterised by a runny nose and sweaty forehead. One of the characteristics of this disorder is headache on one side of the head.

Causes

The cause of SUNCT is unknown, but some think it involves a disturbance in a particular part of the brain, which may also involve the trigeminal nerve.

Signs and symptoms

Patients report brief attacks of unilateral, stabbing and throbbing headache (lasting between 5 and 240 seconds), as well as red and watery eyes. Half of the patients still feel some pain between attacks. During an attack, patients may also have a blocked-up nose, swollen eyelids and a red face, which may be sweaty.

How is SUNCT diagnosed?

The diagnosis is based on the clinical picture. It is important to get a complete neurological examination, especially of the nerves in the head. A typical characteristic of this disorder appears to be that patients do not respond to indomethacine.

Do I need additional examinations?

  • Diagnostic examination for other non-physical factors important for your pain, have already been done by yourself trough filling out your pain questionnaires.
  • MRI scan of the brain.

What are my treatment possibilities?

Multidisciplinary Treatment

Depending on the cause of your pain, your pain specialist will decide whether or not to embark on physical treatment. Based on the results of the completed pain questionnaire, additional examinations can be carried out and, apart from physical treatment, other methods of treatment will be suggested.

 

Non-physical Treatments

If the results of your pain questionnaire are abnormal, your pain specialist will offer you one of the non-physical treatments listed below:

Physical Treatments

Medication

  • Neuropathic pain medication
  • Oxygen inhalation (100%, 12 liter/min) to stop the attacks (by a neurologist)
  • Intravenous lidocaine 1.5-3.5 mg/kg/hour to stop the attacks (by a neurologist)


Interventional Pain Treatments

 

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