SUNCT/SUNA: Case series presenting in an orofacial pain clinic

Beth R. Groenke, Iryna Hryvenko Daline, Donald R. Nixdorf

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
JournalCephalalgia
DOIs
StateAccepted/In press - 2020

Bibliographical note

Publisher Copyright:
© International Headache Society 2020.

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

  • dentistry
  • 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
  • Trigeminal autonomic cephalalgias (TAC)

PubMed: MeSH publication types

  • Journal Article

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