Journal
CEPHALALGIA
Volume 41, Issue 6, Pages 665-676Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/0333102420977292
Keywords
Trigeminal autonomic cephalalgias (TAC); short-lasting unilateral neuralgiform facial attacks with autonomic signs (SUNFA); short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT); short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA); short-lasting unilateral neuralgiform headache attacks (SUNHA); dentistry; temporomandibular disorders
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This study retrospectively analyzed data of 6 patients who met the diagnostic criteria for SUNCT/SUNA, finding that headache attacks were often located in the V1/V2 trigeminal distribution, accompanied by intraoral pain and cranial autonomic symptoms. Common triggers included touching the nose or intraoral area.
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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