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Where does the severe pain come from? The shocking truth behind SUNCT symptoms!
Brief unilateral neuralgic headache with conjunctival injection and tearing (SUNCT syndrome) is a rare headache disorder belonging to the category of trigeminal autonomic headaches (TACs). Symptoms of the disease include severe burning, tingling, or electric-like headaches, centered near the eyes, and usually only on one side of the body. Headache attacks are usually accompanied by characteristic intracranial autonomic symptoms. Each attack lasts from five seconds to six minutes and may occur as many as two hundred times a day.
For those affected, SUNCT episodes can disrupt daily life, and for many, the excruciating pain becomes a normal part of their lives.
Symptoms and characteristics
People affected by SUNCT often describe their headache attacks as excruciatingly painful. These episodes often interfere with daily activities, but most people do not require hospitalization. According to statistics, the average number of attacks per day is about 60, ranging from 3 to 200, and each attack can be divided into a single stabbing pain, a combination of stabbing pains, and a sawtooth-shaped continuous attack. The nature of the pain also varies depending on the length of the attack and is often described as sharp, stabbing, pulsating or burning.
SUNCT is often accompanied by intracranial autonomic symptoms, including tearing, ipsilateral eyelid ptosis, eyelid edema, nasal congestion, and conjunctival congestion.
Frequency and duration of attacks
The average duration of an attack ranges from five seconds to 240 seconds and usually occurs in areas such as the eye socket, above the eyelid, or in the ear. Less than 2% of attacks occur at night. Most SUNCT-type episodes are continuous, but occasionally they occur in cycles. Even when ongoing, episodes may recur at certain times.
Many patients will trigger SUNCT attacks in daily small stimuli, such as touching the face, washing the face, eating, talking, giving a speech, etc.
Diagnosis
It is very important to correctly diagnose SUNCT versus cluster headaches. Although the symptoms of the two are somewhat similar, cluster headaches usually last longer and are not accompanied by intracranial autonomic symptoms. According to the International Headache Society, the diagnostic criteria for SUNCT include the following:
- Pain location: unilateral eye socket, above the eyelid or temporal area, etc.
- Number of attacks per day: 3 to 200.
- Duration of attack: 5-240 seconds.
The pathophysiology of SUNCT is not fully understood. Studies have shown a link between the hypothalamus and the disorder, with functional magnetic resonance imaging and deep brain stimulation showing that the hypothalamus is activated during headache attacks. This has sparked more research into the mechanisms driving the disease.
TreatmentAlthough there is currently no permanent cure, certain anti-epileptic drugs such as valproic acid and lamotrigine can effectively improve patients' symptoms. The use of intravenous lidocaine has also shown efficacy in some patients, providing relief during administration. The quest to find effective treatments continues with the combination of various drugs and treatments.
Due to the rarity and common misdiagnosis of SUNCT, its understanding and accuracy are particularly important so that appropriate treatment options can be provided to more patients.
For those affected by SUNCT, this dramatic pain is more than just a physical challenge; it also changes their quality of life and daily activities. Will research and developments in this rare condition lead to greater understanding and treatment options? How many people are facing the pain of waiting for an accurate diagnosis?
