sunct syndrome


Summary: A primary headache disorder that is characterized by frequent short-lasting, unilateral, neuralgiform pain attacks in the ocular area, with CONJUNCTIVA fluid-filling and tearing. SUNCT syndrome is usually resistant to treatment.

Top Publications

  1. Williams M, Broadley S. SUNCT and SUNA: clinical features and medical treatment. J Clin Neurosci. 2008;15:526-34 pubmed publisher
    ..Lamotrigine is effective in the majority of cases and subcutaneous lignocaine is useful as acute treatment for severe recalcitrant attacks. ..
  2. Etemadifar M, Maghzi A, Ghasemi M, Chitsaz A, Kaji Esfahani M. Efficacy of gabapentin in the treatment of SUNCT syndrome. Cephalalgia. 2008;28:1339-42 pubmed publisher
    This study was designed to evaluate the efficacy of gabapentin (GBP) in the treatment of SUNCT syndrome on a relatively large sample of Persian patients...
  3. de Lourdes Figuerola M, Bruera O, Pozzo M, Leston J. SUNCT syndrome responding absolutely to steroids in two cases with different etiologies. J Headache Pain. 2009;10:55-7 pubmed publisher
    ..We are presenting now two cases absolutely responders to steroid therapy, one of them a SUNCT-like secondary to a prolactinoma and the other primary. ..
  4. Effendi K, Jarjoura S, Mathieu D. SUNCT syndrome successfully treated by gamma knife radiosurgery: case report. Cephalalgia. 2011;31:870-3 pubmed publisher
    The SUNCT syndrome (short-unilateral neuralgiform headache with conjunctival injection and tearing) can be very disabling for affected patients and is often refractory to medical management...
  5. Mondéjar B, Cano E, Perez I, Navarro S, Garrido J, Velasquez J, et al. Secondary SUNCT syndrome to a variant of the vertebrobasilar vascular development. Cephalalgia. 2006;26:620-2 pubmed
  6. Arroyo A, Durán X, Beldarrain M, Pinedo A, Garcia Monco J. Response to intravenous lidocaine in a patient with SUNCT syndrome. Cephalalgia. 2010;30:110-2 pubmed publisher
    ..We report a patient with SUNCT syndrome who showed a clear-cut and consistent response to intravenous lidocaine therapy, which proved superior to ..
  7. Dora B. SUNCT syndrome with dramatic response to oxcarbazepine. Cephalalgia. 2006;26:1171-3 pubmed
  8. Rozen T. Resolution of SUNCT after removal of a pituitary adenoma in mild acromegaly. Neurology. 2006;67:724 pubmed
  9. Marziniak M, Breyer R, Evers S. SUNCT syndrome successfully treated with the combination of oxcarbazepine and gabapentin. Pain Med. 2009;10:1497-500 pubmed publisher
    ..The pain modulation is often very difficult. The reported SUNCT patient is the first who responded to a combination treatment of oxcarbazepine and gabapentin. ..

More Information


  1. Cosentino G, Fierro B, Puma A, Talamanca S, Brighina F. Different forms of trigeminal autonomic cephalalgias in the same patient: description of a case. J Headache Pain. 2010;11:281-4 pubmed publisher
    ..This report supports the theory that common mechanisms could be involved in pathophysiology of different primary headache syndromes. ..
  2. Matharu M, May A. Functional and structural neuroimaging in trigeminal autonomic cephalalgias. Curr Pain Headache Rep. 2008;12:132-7 pubmed
    ..These studies suggest that the hypothalamus plays a crucial role in the pathophysiology of TACs, thereby supporting the notion that these disorders are primarily due to central rather than peripheral mechanisms. ..
  3. Rocha Filho P, Rabello G, Galvão A, Fortini I, Calderaro M, Carrocini D. [Gabapentin in the treatment of SUNCT syndrome]. Arq Neuropsiquiatr. 2007;65:503-5 pubmed
    ..Administration of gabapentin (1200 mg per day) led to complete resolution of the pain attacks, but the patient continue to have episodes of conjunctival injection. ..
  4. Bosco D, Labate A, Mungari P, Vero S, Fava A. SUNCT and high nocturnal prolactin levels: some new unusual characteristics. J Headache Pain. 2007;8:114-8 pubmed
    ..We report a case of SUNCT syndrome linked to a pituitary micro-adenoma, with only nocturnal attacks...
  5. Jimenez Caballero P. SUNCT syndrome in a patient with prolactinoma and cabergoline-induced attacks. Cephalalgia. 2007;27:76-8 pubmed
    ..We report a patient with prolactinoma and cabergoline-induced SUNCT attacks and the literature is reviewed for a better understanding of the pathophysiology. ..
  6. Kutschenko A, Liebetanz D. Meningioma causing gabapentin-responsive secondary SUNCT syndrome. J Headache Pain. 2010;11:359-61 pubmed publisher
    ..In this study, we describe the first case of secondary SUNCT syndrome caused by a meningioma. So far, a clearly effective therapy for SUNCT syndrome has not been known...
  7. Cohen A, Matharu M, Goadsby P. Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) or cranial autonomic features (SUNA)--a prospective clinical study of SUNCT and SUNA. Brain. 2006;129:2746-60 pubmed
  8. Alore P, Jay W, Macken M. SUNCT syndrome: Short-lasting Unilateral Neuralgiform headache with Conjunctival injection and Tearing. Semin Ophthalmol. 2006;21:9-13 pubmed
    The SUNCT syndrome refers to Short-lasting Unilateral Neuralgiform headache with Conjunctival injection and Tearing...
  9. Zabalza R. Sustained response to botulinum toxin in SUNCT syndrome. Cephalalgia. 2012;32:869-72 pubmed publisher
    ..Efficacy has been maintained for 18 months with 3-monthly infiltrations, with no adverse effects. OnabotulinumtoxinA should be added to the limited therapeutic arsenal available for the treatment of refractory cases of SUNCT. ..
  10. Vikelis M, Xifaras M, Mitsikostas D. SUNCT syndrome in the elderly. Cephalalgia. 2005;25:1091-2 pubmed
  11. Pareja J, Cuadrado M. SUNCT syndrome: an update. Expert Opin Pharmacother. 2005;6:591-9 pubmed
    ..However, well-designed clinical trials are required before these therapeutic options can be sufficiently validated. ..
  12. Trauninger A, Alkonyi B, Kovacs N, Komoly S, Pfund Z. Methylprednisolone therapy for short-term prevention of SUNCT syndrome. Cephalalgia. 2010;30:735-9 pubmed publisher
    ..orally administered methylprednisolone in eight headache periods of three patients with idiopathic, episodic SUNCT syndrome. The remission was maintained until the period was over in all cases...
  13. Kuhn J, Vosskaemper M, Bewermeyer H. SUNCT syndrome: a possible bilateral case responding to topiramate. Neurology. 2005;64:2159 pubmed
  14. Williams M, Bazina R, Tan L, Rice H, Broadley S. Microvascular decompression of the trigeminal nerve in the treatment of SUNCT and SUNA. J Neurol Neurosurg Psychiatry. 2010;81:992-6 pubmed publisher
    ..Ipsilateral hearing loss was observed in one case. Medically intractable SUNCT and SUNA subjects with a demonstrable aberrant arterial loop impinging on the trigeminal nerve on neuroimaging may benefit from microvascular decompression. ..
  15. Adamo M, Drazin D, Popp A. Short-lasting, unilateral neuralgiform headache attacks with conjunctival injection and tearing syndrome treated successfully with transsphenoidal resection of a growth hormone-secreting pituitary adenoma. J Neurosurg. 2008;109:123-5 pubmed publisher
    ..In this paper the authors present a patient with a growth hormone-secreting pituitary adenoma who experienced resolution of SUNCT syndrome after transsphenoidal tumor resection.
  16. Boes C, Swanson J. Paroxysmal hemicrania, SUNCT, and hemicrania continua. Semin Neurol. 2006;26:260-70 pubmed
    ..Hemicrania continua was previously classified as one of the TACs. Despite their common elements, individually these headaches differ with respect to attack duration, frequency, and response to indomethacin. ..
  17. Cohen A. Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing. Cephalalgia. 2007;27:824-32 pubmed
    ..Preventive treatments include lamotrigine, gabapentin and topiramate. The role of hypothalamic involvement in SUNCT and SUNA as TACs is considered. ..
  18. Pareja J, Alvarez M. The usual treatment of trigeminal autonomic cephalalgias. Headache. 2013;53:1401-14 pubmed publisher
    ..Lamotrigine (100-300?mg/day) is the preventive drug of choice for SUNCT. Gabapentin (800-2700?mg/day), topiramate (50-300?mg/day), and carbamazepine (200-1600?mg/day) may be of help. ..
  19. Rosenberg Nordmann M, Tolle T, Sprenger T. [Trigeminal autonomic cephalgias: diagnostic and therapeutic implications]. MMW Fortschr Med. 2007;149:39-41 pubmed
    ..The therapeutic strategies, however, differ considerably. Although unusual, structural lesions in TACs have been described, affecting the therapeutic management. ..
  20. Goadsby P, Cohen A. [Pathophysiology and treatment of trigeminal autonomic cephalalgias]. Schmerz. 2008;22 Suppl 1:7-10 pubmed publisher
    ..PH) and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT syndrome)...
  21. Theeler B, Joseph K. SUNCT and optic nerve hypoplasia. J Headache Pain. 2009;10:381-4 pubmed publisher
    ..SUNCT with an early age of onset may be associated with congenital abnormality of the hypothalamic-pituitary axis. ..
  22. Sjaastad O. Chronic paroxysmal hemicrania, hemicrania continua and SUNCT: the fate of the three first described cases. J Headache Pain. 2006;7:151-6 pubmed
    ..There was no tachyphylaxis. Both patients treated with indomethacin developed gastric ulcer. And both had gastric surgery. Indomethacin therapy may be a life-long affair. The risk of gastric complications may be substantial. ..
  23. Jansen J, Sjaastad O. Hemicrania with massive autonomic manifestations and circumscribed eyelid erythema. Acta Neurol Scand. 2006;114:334-9 pubmed
    ..This constellation probably alienates it from SUNCT. ..
  24. Tada Y, Ikuta N, Negoro K. Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA). Intern Med. 2009;48:2141-4 pubmed
    ..The etiology and pathology of SUNA has yet to be documented. We report an 18-year-old man with SUNA. Lomerizine hydrochloride which is used as a preventive medicine for migraine, improved his headaches. ..
  25. Baabor M, Rosas C, Perez Limonte L. SUNCT responsive to percutaneous balloon compression of the gasserian ganglion--10-year follow-up. Headache. 2010;50:143-5 pubmed publisher
    ..The patient remains pain free after 10-year follow-up. This may be the first literature report of SUNCT in Chile. ..
  26. Guerrero Peral A, Martín Polo J, Iglesias F, Gutierrez Martin F, Martínez Maldonado M, Tejero M. [Trigeminal involvement in SUNCT syndrome]. Rev Neurol. 2008;46:510-1 pubmed
  27. Lambru G, Matharu M. Management of trigeminal autonomic cephalalgias in children and adolescents. Curr Pain Headache Rep. 2013;17:323 pubmed publisher
    ..Awareness of typical clinical pictures of these excruciating headaches is essential to allow prompt initiation of the appropriate management. ..
  28. Rinaldi F, Rao R, Venturelli E, Liberini P, Gipponi S, Pari E, et al. Where SUNCT contacts TN: a case report. Headache. 2013;53:1492-5 pubmed publisher
    ..Many authors described a SUNCT case deriving from TN or vice versa, suggesting that these conditions are strongly related. Every case of transformed TN or SUNCT should therefore be reported to gather and compare further information. ..
  29. Jiménez Caballero P, Portilla Cuenca J, Casado Naranjo I. Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) secondary to epidermoid cyst in the right cerebellopontine angle successfully treated with surgery. J Headache Pain. 2011;12:385-7 pubmed publisher
    ..Realization of a brain MRI would rule out injuries that causes this type of syndrome. ..
  30. Ikawa M, Imai N, Manaka S. A case of SUNCT syndrome responsive to zonisamide. Cephalalgia. 2011;31:501-3 pubmed publisher
    ..This is the first case report to describe zonisamide alone completely eliminating SUNCT symptoms. Zonisamide should be considered a viable candidate drug for the treatment of SUNCT. ..
  31. de Siqueira S, Nóbrega J, Teixeira M, de Siqueira J. SUNCT syndrome associated with temporomandibular disorders: a case report. Cranio. 2006;24:300-2 pubmed
    ..b>SUNCT syndrome was treated with a balloon microcompression procedure of the trigeminal ganglion, and the myofascial pain with ..
  32. Panconesi A, Bartolozzi M, Guidi L. SUNCT syndrome or first division trigeminal neuralgia associated with cerebellar hypoplasia. J Headache Pain. 2009;10:461-4 pubmed publisher
    ..However, a hypoplastic posterior cranial fossa characterizes also Chiari I malformation. The difficult differential diagnosis between SUNCT and TN and their relation with posterior skull malformations is debated. ..
  33. Franzini A, Marras C, Tringali G, Leone M, Ferroli P, Bussone G, et al. Chronic high frequency stimulation of the posteromedial hypothalamus in facial pain syndromes and behaviour disorders. Acta Neurochir Suppl. 2007;97:399-406 pubmed
    ..Finally, we also tested the same procedure in three patients with refractory atypical facial pain, but unfortunately, they did not respond to this treatment. ..
  34. Eguia P, Garcia Monco J, Ruiz Lavilla N, Diaz Konrad V, Monton F. SUNCT and trigeminal neuralgia attributed to meningoencephalitis. J Headache Pain. 2008;9:51-3 pubmed publisher
    We describe a 46-year-old female with viral meningoencephalitis (likely varicella-zoster virus) who developed a SUNCT syndrome followed a few days later by trigeminal neuralgia...
  35. Zidverc Trajkovic J, Vujovic S, Sundic A, Radojicic A, Sternic N. Bilateral SUNCT-like headache in a patient with prolactinoma responsive to lamotrigine. J Headache Pain. 2009;10:469-72 pubmed publisher
    ..We have reported a case of bilateral SUNCT-like headache secondary to a prolactinoma and responsive to lamotrigine treatment. ..
  36. Kursun O, Arsava E, Oguz K, Tan E, Kansu T. SUNCT associated with Devic's syndrome. Cephalalgia. 2006;26:221-4 pubmed
  37. Guerreiro R, Casimiro M, Lopes D, Marques J, Fontoura P. Video NeuroImage: symptomatic SUNCT syndrome cured after trigeminal neurovascular contact surgical decompression. Neurology. 2009;72:e37 pubmed publisher
  38. Bichuetti D, Yamaoka W, Bastos J, Carvalho D. Bilateral SUNCT syndrome associated to chronic maxillary sinus disease. Arq Neuropsiquiatr. 2006;64:504-6 pubmed
    b>SUNCT syndrome (short lasting unilateral neuralgiform headache with conjunctival injection and tearing) is defined as short attacks of periorbital unilateral pain and accompanied by ipsilateral lacrimation and redness of the same eye...
  39. Ito Y, Yamamoto T, Ninomiya M, Mizoi Y, Itokawa K, Tamura N, et al. Secondary SUNCT syndrome caused by viral meningitis. J Neurol. 2009;256:667-8 pubmed publisher
  40. Ito Y, Imai K, Suzuki J, Nishida S, Kato T, Yasuda T. [Japanese SUNCT patient responsive to gabapentin]. Rinsho Shinkeigaku. 2011;51:275-8 pubmed
    ..Furthermore, the long-term clinical course and therapeutic outcome in SUNCT remain unknown. A therapeutic strategy and optimal dosage of medications including gabapentin should be established for the treatment of SUNCT. ..
  41. Bartsch T, Falk D, Knudsen K, Reese R, Raethjen J, Mehdorn H, et al. Deep brain stimulation of the posterior hypothalamic area in intractable short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT). Cephalalgia. 2011;31:1405-8 pubmed publisher
    ..This case supports the idea of a central origin of SUNCT and shows that deep brain stimulation of the hypothalamic region can be effective in the treatment of the chronic form of this rare disorder. ..
  42. Paliwal V, Singh P, Kumar A, Rahi S, Gupta R. Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) with preserved refractory period: report of three cases. J Headache Pain. 2012;13:167-9 pubmed publisher
    ..We report three patients of SUNCT syndrome with preserved intervening refractory period of variable duration observed at different times...
  43. Domingos J, Pereira P, Roriz M, Xavier A, Magalhaes M, Monteiro P. Cavernous sinus dural fistula 'mimicking' SUNCT. Cephalalgia. 2012;32:263-4 pubmed publisher
  44. Leroux E, Schwedt T, Black D, Dodick D. Intractable SUNCT cured after resection of a pituitary microadenoma. Can J Neurol Sci. 2006;33:411-3 pubmed
  45. Caminero A, Mateos V. [The hypothalamus in SUNCT syndrome: similarities and differences with the other trigeminal-autonomic cephalalgias]. Rev Neurol. 2009;49:313-20 pubmed
    ..Future studies will allow the enigma of SUNCT and the other TAC to be explained. ..
  46. Irimia P, Gallego Perez Larraya J, Martinez Vila E. Seasonal periodicity in SUNCT syndrome. Cephalalgia. 2008;28:94-6 pubmed
  47. Bogorad I, Blum S, Green M. A case of MS presenting with SUNCT status. Headache. 2010;50:141-3 pubmed publisher
  48. Sciruicchio V, Sardaro M, Gagliardi D, Trabacca A, Galeone D, de Tommaso M. A case of early-onset and monophasic trigeminal autonomic cephalalgia: could it be a SUNCT?. J Headache Pain. 2010;11:363-5 pubmed publisher
  49. Brown R, Pass B. Orofacial pain due to trigeminal autonomic cephalgia with features of short-lasting neuralgiform headache attacks with conjunctival injection and tearing: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114:e13-9 pubmed publisher
    ..Diagnostic, etiologic, and therapeutic issues related to SUNCT syndrome are discussed...
  50. Pong D, Marom T, Pine H. Short-lasting unilateral neuralgiform headache attacks with conjunctiva injection and tearing presenting as sphenoiditis. Am J Otolaryngol. 2013;34:166-8 pubmed publisher
    ..This case demonstrates an additional spectrum of acute sinusitis, which should be familiar to the otolaryngologist population. ..
  51. Lambru G, Bakar N, Matharu M. SUNA and red ear syndrome: a new association and pathophysiological considerations. J Headache Pain. 2013;14:32 pubmed publisher
    ..Lamotrigine was beneficial for her SUNA but not for the RES. Both these disorders are extremely rare therefore their coexistence in the same individual may suggest similar pathophysiological mechanisms rather than a chance association...
  52. Benoliel R, Eliav E. Primary headache disorders. Dent Clin North Am. 2013;57:513-39 pubmed publisher
    ..This article describes the features and treatment of these disorders. ..
  53. Chitsantikul P, Becker W. SUNCT, SUNA and pituitary tumors: clinical characteristics and treatment. Cephalalgia. 2013;33:160-70 pubmed publisher
    ..Tumor removal provided major improvement in three out of five patients. Medical treatment was only partially effective. ..