Sunct syndrome

SUNCT Syndrome is shortlived unilateral neuraligiform headache with conjunctival injecyion and tearing.

1. SUNCT SYNDROME GUIDE – DR. L. S. PATIL STUDENT – DR. DEEPAK R. CHINAGI

2. SUNCT SYNDROME Short-lasting Unilateral N euralgiform headache with C onjunctival injection and Tearing (Lacrimation). It Belongs to a group of headache disorders called Trigeminal Autonomic Cephalalgias (TACs) TACs are caused by activation of Autonomic Nervous System in Trigeminal Nerve(5 th Cranial nerve, which carries sensory innervations from the face)

3. Each attack lasts for 5 seconds to 6 minutes (Short lived) Character of Headache – Burning , Stabbing, Electrical headache. Orbital area of the face is involved. Associated with conjunctival injection and redness and lacrimation. Age – 50 years with male preponderance

4. Severity of headache: often headache is very severe and patients may rate the pain upto 9/10 on numerical scale for pain. Per day around 60 to 200 attacks may occur.

5. Inetrnational Headache Society – SUNCT diagnostic Criteria Type of attack — Attacks of unilateral orbital, supraorbital , or temporal ares from stabbing or pulsating pain accompanied by ipsilateral conjunctival injection and lacrimation. Number of attacks per day — 3 to 200 attacks per day. Attack load in minutes per day — 5–240 seconds

6. Pathophysiology of SUNCT Syndrome Activation of posterior hypothalamus and brainstem during attacks of SUNCT Syndrome. Activation of Trigemino -Cervical Complex. It is connected with Hypothalamus and Orexin is the primary neurotransmitter here. Elevated Prolactin levels during night is associated with nocturnal SUNCT Syndrome. Rarely A pituitary tumor or Paranasal sinusitis cause the appearance of SUNCT Syndrome.

7. Treatment of SUNCT Syndrome Antiepileptic Drugs Pregabalin Gabapentin Topiramate Carbamazepine Lamotrigine Intravenous Lidocaine Methyprednisolone Verapamil (Calcium Channel Blocker)

8. NSAIDs don’t provide adequate pain control

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