SUNCT in Multiple Sclerosis

SUNCT in a Patient With Multiple Sclerosis: A Case Report

“…Follow‐up MRI T2WI revealed hyperintensities at the left trigeminal tract topography. These neuroimages support previous explanations of SUNCT's pathophysiology …”

Pain in multiple sclerosis: A systematic review of neuroimaging studies

“…1). Thirty-eight met the inclusion criteria (Alstadhaug et al, 2008; Andrade et al, 2012; Athanasiou et al, 2005; Balasa and Bajko, 2010; Bentley et al, 2002; Broggi et al, 2004; Burkey and Abla-Yao, 2010; Carrieri et al, 2009; Cordella et al, 2009; Cruccu et al, 2009; da Silva et al, 2005; Davey and Al-Din, 2004; Deppe et al, 2013; de Santi et al, 2009; Donat, 2012; Eldridge et al, 2003; Fragoso and Brooks, 2007; Gass et al, 1997; Gee et al, 2005; Gentile et al, 2007; González-Quintanilla et al, 2012; Haas et al, 1993; Hellwig et al, 2006; Kister et al, 2010; Leandri et al, 1999; Liu et al, 2008; Marchettini et al, 2006; Meaney et al, 1995; Minagar and Sheremata, 2000; Nakashima et al, 2001; Pichiecchio et al, 2007; Ramirez-Lassepas et al, 1992; Svendsen et al, 2011; Tanei et al, 2010; Tortorella et al, 2006; Tosi et al, 1998; Vilisaar and Constantinescu, 2006; Yetimalar et al, 2008). Of these, 16 were case reports (Alstadhaug et al, 2008; Andrade et al, 2012; Bentley et al, 2002; Burkey and Abla-Yao, 2010; Carrieri et al, 2009; Davey and Al-Din, 2004; Donat, 2012; Gentile et al, 2007; González-Quintanilla et al, 2012; Haas et al, 1993; Leandri et al, 1999; Liu et al, 2008; Pichiecchio et al, 2007; Tanei et al, 2010; Tosi et al, 1998; Vilisaar and Constantinescu, 2006), nine were case series (Athanasiou et al, 2005; Cordella et al, 2009; de Santi et al, 2009; Fragoso and Brooks, 2007; Hellwig et al, 2006; Marchettini et al, 2006; Meaney et al, 1995; Minagar and Sheremata, 2000; Nakashima et al, 2001), and 13 were investigational studies (<...>…”

“…Lesions were identified in the CNS ( i.e. central neuropathic pain) in 21 studies; of these, lesions were located in the spinal cord in six studies ((Alstadhaug et al, 2008; Burkey and Abla-Yao, 2010; Tosi et al, 1998) (de Santi et al, 2009) — three cases (Hellwig et al, 2006) — four cases: only two documented with MRI (Marchettini et al, 2006) — five cases), in the brainstem in 13 studies ((Bentley et al, 2002; Donat, 2012; Gentile et al, 2007; González-Quintanilla et al, 2012; Haas et al, 1993; Leandri et al, 1999; Liu et al, 2008; Tanei et al, 2010) (Meaney et al, 1995; Nakashima et al, 2001; Vilisaar and Constantinescu, 2006) — one case (Fragoso and Brooks, 2007) — two cases (Cordella et al, 2009) — five cases), in the thalamus in one study (Deppe et al, 2013) and in multiple locations throughout the pyramidal tract in another study (Andrade et al, 2012). …”

“…This emphasis is at odds with estimates of prevalence of pain syndromes in MS — for example TN is reported in 1–5% of MS patients, as compared to an overall pain prevalence of approximately 50% (Polman et al, 2011). Other cranial pain syndromes examined in included studies (such as occipital or glossopharyngeal neuralgia (Carrieri et al, 2009; de Santi et al, 2009; Minagar and Sheremata, 2000; Vilisaar and Constantinescu, 2006)) are even less common. These observations could suggest that studies identifying neuroradiological correlates of neuropathic pain syndromes in general, and headache or facial pain syndromes in particular, are disproportionately represented by the current literature (Bax and Moons, 2011).…”

Intravenous Lidocaine and Mexiletine in the Management of Trigeminal Autonomic Cephalalgias

“…Secondary headaches may mimic SUNCT or SUNA. Secondary causes are usually related to pathology in the posterior fossa or pituitary gland, such as brainstem infarction [59], multiple sclerosis [60], arteriovenous malformation [61], or prolactinoma.…”