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Short-term unilateral neuralgic headaches with conjunctival injection and lacrimation

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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This rare syndrome is not well understood. It is characterized by short-term attacks of unilateral pain; the duration of seizures is much less than with other forms of trigeminal vegetative cephalgia. Frequently seizures are accompanied by pronounced lacrimation and reddening of the eye on the side of the pain.

3.3. Short-term unilateral neuralgic headaches with conjunctival injection and lacrimation (SUNCT syndrome)

A. At least 20 seizures that meet BD criteria.
B. Attacks of unilateral pulsating pain of orbital, supraorbital or temporal localization of duration 5-240 s.
C. Pain is accompanied by ipsilateral injections of the conjunctiva and lacrimation.
D. Seizures occur at a frequency of 3 to 200 times a day.
E. Not related to other causes (disorders).

Along with the reddening of the sclera and tearing on the side of pain, patients may also have nasal congestion, rhinorrhea and eyelid edema. The peculiarity of this syndrome is a wide spread of frequency and duration of seizures.

Differential-diagnostic measures

Attacks with short-term unilateral neuralgic headaches with conjunctival injection and lacrimation sometimes have to be differentiated from attacks of neuralgia of the trigeminal nerve with involvement of the ophthalmic branch. In addition, according to the literature, the same symptoms are possible with lesions localized in the posterior cranial fossa or involving the pituitary gland. Therefore, the diagnosis of the primary form of trigeminal vegetative cephalgia "short-term unilateral neuralgic headaches with conjunctival injection and lacrimation" can be made only after a thorough examination (including methods of neuroimaging) excludes the secondary nature of the symptoms.

Treatment

Therapeutic approaches are not developed. Taking into account the assumed general mechanisms of trigeminal vegetative cephalges, it is possible to use NSAIDs, anticonvulsants, glucocorticoids. However, the effectiveness of these groups of drugs has not been proven.

trusted-source [1], [2], [3], [4], [5], [6], [7], [8], [9], [10]

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