A Case of SUNCT Syndrome which Showed Marked Improvement with Carbamazepine and Discussion on Nosologic Aspect of SUNCT Syndrome

J Korean Neurol Assoc > Volume 16(3); 1998 > Article

Journal of the Korean Neurological Association 1998;16(3): 392-397.

카바마제핀에 효과를 보인 SUNCT 증후군 1 예와 SUNCT 증후군의 질병분류적 측면에 대한 고찰

전북대학교 의과대학 신경과학교실

A Case of SUNCT Syndrome which Showed Marked Improvement with Carbamazepine and Discussion on Nosologic Aspect of SUNCT Syndrome

Man-Wook Seo, M.D.

Department of Neurology, Chunbuk National University Medical School

Abstract

SUNCT syndrome is a headache syndrome characterized by short-lasting(usually 15-120 sec), unilateral head paroxysms localized in the peri-ocular area, accompanied by conjunctival injection, lacrimation, nasal stuffiness, rhinorrhea, and subclinical forehead sweating, all on the symptomatic side. We experienced a new SUNCT syndrome case. 57-year-old patient had been suffering from right orbital pain attacks since he was 54. The pain, of an "electrical" or "burning" character, was moderate to severe in intensity. Single attacks lasted for 30-60 seconds each and were accompanied by prominent ipsilateral conjunctival injection and tearing as well as slight rhinorrhea. His symptoms were relieved by carbamazepine. Carbamazepine treatment seemingly brought about marked decrease in the frequency and severity of attacks. This case may be the first reported SUNCT syndrome case in Korea. Furthermore this case may shed light on the nosologic point view of SUNCT syndrome. The suspected pathophysiology of trigeminal neuralgia is expansion of the low threshold portions of the receptive fields owing to loss of surround inhibition. Carbamazepine facilitate afferent inhibition and depress excitatory transmission in the trigeminal nucleus. So the effectiveness to carbamazepine has been considered as one of diagnostic criteria of trigeminal neuralgia. Through the survey of previous reported cases including our case, it is suspected that SUNCT syndrome be closer to trigeminal neuralgia rather than cluster headache. We discussed several viewpoints for the nosologic aspect of SUNCT syndrome in this report. Key words : SUNCT. Trigeminal Neuralgia, Cluster Headache