SUNCT and SUNA: Clinical features and medical treatment

Williams, Max; Broadley, Simon

doi:10.1016/j.jocn.2006.09.006

Cited by 117 publications

(169 citation statements)

References 55 publications

(44 reference statements)

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“…The range of daily dose varied between 25 and 600 mg [6]. In an Australian series, the response to lamotrigine depended on the subtype of SUNCT; lamotrigine was reported to produce an excellent response in episodic SUNCT, but a poor response in those with the chronic form [2].…”

Section: Lamotriginementioning

confidence: 99%

“…Williams and Broadley [2], who systematically looked for trigeminal neurovascular conflict with dedicated trigeminal MRI scans, found a high proportion of ipsilateral vascular loops in contact with the trigeminal nerve in SUNCT and SUNA (88 %, n = 15/17). This supported the notion of MVD being a potential treatment for these conditions.…”

Section: Microvascular Decompression Of the Trigeminal Nervementioning

confidence: 99%

“…SUNCT is believed to be rare with an estimated prevalence of 6.6 per 100,000 and an annual incidence of 1.2 per 100,000 [2]. SUNA seems to be even rarer than SUNCT, probably five times less frequent than the latter [3].…”

Section: Introductionmentioning

confidence: 95%

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SUNCT and SUNA: medical and surgical treatments

Lambru

Matharu

2013

Neurol Sci

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Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are rare and often disabling primary headache disorders. Their management can be challenging. The abortive therapies are not generally useful as the attacks are relatively short lasting. A myriad of pharmacological preventive treatments have been tried in single case reports or small series in an openlabel fashion. Lamotrigine, as an oral preventive treatment, and lidocaine, as an intravenous transitional treatment, seem to be the most effective therapies. For medically intractable chronic forms of SUNCT and SUNA, several surgical approaches have been tried. These include ablative procedures involving the trigeminal nerve or the Gasserian ganglion, microvascular decompression of the trigeminal nerve, and neurostimulation techniques. This review provides an overview of the current pharmacological and surgical options for SUNCT and SUNA syndromes.

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Section: Lamotriginementioning

confidence: 99%

Section: Microvascular Decompression Of the Trigeminal Nervementioning

confidence: 99%

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SUNCT and SUNA: medical and surgical treatments

Lambru

Matharu

2013

Neurol Sci

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“…Agents were selected on the basis of reported efficacy in this condition and local experience (Cohen et al, 2006, Williams andBroadley, 2008). A failed trial was defined as lack of response, intolerable side effects or contradiction to the use of the drug.…”

Section: Methodsmentioning

confidence: 99%

Ventral tegmental area deep brain stimulation in refractory short-lasting unilateral neuralgiform headache attacks

Miller

Akram

Lagrata

et al. 2016

Brain

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“…The patients with SUNA remained pain-free for 2 days to 12 weeks after infusion. Williams and Broadley [64] gave lidocaine either as an infusion or subcutaneous injection for episodic and chronic SUNCT or SUNA. Thirteen of the 14 patients, including all 9 patients with chronic forms, had an excellent result, with most patients becoming attack-free.…”

Section: Intravenous Lidocaine In the Treatment Of Sunct And Sunamentioning

confidence: 99%

Intravenous Lidocaine and Mexiletine in the Management of Trigeminal Autonomic Cephalalgias

Marmura

2010

Curr Pain Headache Rep

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Lidocaine and mexiletine are class 1B antiarrhythmic drugs that act on sodium channels. Lidocaine is also an important anesthetic and topical agent that is useful in the treatment of multiple pain disorders, and mexiletine is commonly used for neuropathic pain and myotonia. Both intravenous lidocaine and mexiletine are increasingly used to treat pain syndromes and appear to be particularly effective in neuropathic pain. This suggests a role for these agents in patients with headache disorders. This article describes the role of intravenous lidocaine and mexiletine in the management of headache and trigeminal autonomic cephalalgias based on the published literature to date and provides practical guidelines for their use.

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SUNCT and SUNA: Clinical features and medical treatment

Cited by 117 publications

References 55 publications

SUNCT and SUNA: medical and surgical treatments

SUNCT and SUNA: medical and surgical treatments

Ventral tegmental area deep brain stimulation in refractory short-lasting unilateral neuralgiform headache attacks

Intravenous Lidocaine and Mexiletine in the Management of Trigeminal Autonomic Cephalalgias

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