Short Lasting Neuralgiform Headache with Conjunctival Injection/Lacrimation (SUNCT)

Question 1

DDx

Answer 1

THIS IS THE DDx FOR ALL THE NEURALGIFORM HEADACHES

Longest = cluster headache (15-300 mins)

Longer = trigeminal neuralgia (also more around the mandible than opthalmic area)

Middle = paroxysmal hemicrania (2-30 mins)

Shortest = SUNCT (10 - 240 seconds)

Question 2

Symptoms?

Answer 2

Same as paroxysmal hemicrania but shorter duration

• Orbital temporal severe unilateral head pain

Autonomic signs

• Conjunctival ejection
• Lacrimation
• Sweating on affected side

Question 3

Treatment?

Answer 3

Antiepileptics such as lamotrigine can be given prophylactically