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Short-lasting unilateral neuralgiform headache attacks: Treatment

Manjit S Matharu, MD
Anna S Cohen, MD
Section Editor
Jerry W Swanson, MD, MHPE
Deputy Editor
John F Dashe, MD, PhD


The trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders characterized by unilateral trigeminal distribution pain that occurs in association with ipsilateral cranial autonomic features [1,2]. The TACs include cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks, and hemicrania continua [3]. There are two subtypes of short-lasting unilateral neuralgiform headache attacks [3]:  

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)

Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA)

Although SUNCT and SUNA were once considered to be refractory to therapy, beneficial responses with several categories of medications have been reported in small numbers of patients. However, the evidence consists mainly of case reports and small case series.

This topic will review the treatment and prognosis of SUNCT and SUNA. The clinical features and diagnosis of these headaches are reviewed elsewhere. (See "Short-lasting unilateral neuralgiform headache attacks: Clinical features and diagnosis".)

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Literature review current through: Nov 2017. | This topic last updated: Mar 23, 2017.
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