Case presentation of SUNCT

Abstract

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare condition from the group of primary headaches. Until the year 2015, barely 50 cases were described in medical journals. The differential diagnosis is complicated because of overlapping symptoms with other conditions, the episodic presentation and the neglect or overestimation of the symptoms by the patients, which is in direct correlation with the emotional state of the patient.

Clinical case:

We present a woman, 59 years of age, hospitalized in Second Clinic of Neurology in St. Marina University Hospital, Varna. She was admitted for sharp shooting painful sensations in the right side of her face with episodic occurrence, getting more and more frequent for the prior three days. She described her pains as intense, intolerable, episodic, multiple such episodes during the day, easily provoked by speaking, chewing, loud noises. She was diagnosed with trigeminal neuralgia for such complaints three years prior, for which she did some therapy with unsatisfying results.

Discussion:

Diagnosing this rare type of primary headache is easily obstructed by its unusual symptom characteristics and the overlapping with multiple more common and therefore familiar conditions. Because of the lack of sufficient medical literature on the topic and lack of described cases in the world, diagnosis, follow-up and treatment are still a challenge for the neurologist.