SUNCT syndrome responsive to gabapentin (Neurontin).
A 48-year-old male suffering with SUNCT (severe unilateral neuralgiform headache with conjunctival injection and tearing, rhinorrhea and sub-clinical sweating) presented in 1996 after a 10-year history of multiple failed therapies. The symptoms included strictly left-sided ocular, as well as facial and temple pain. The pain attacks were burning, sharp, shooting and occurred 25 times daily, lasting 2 to 3 minutes with tearing and conjunctival injection. There was no associated nausea or vomiting, but there was photophobia. No other autonomic changes were reported and the pain was not triggerable. Initially Indocin (indomethacin) was tried without significant benefit. Gabapentin (Neurontin) was then started with improvement at 1800 mg per day. The patient was then lost to follow-up for 3 years, as he moved from the Los Angeles area. He returned in 1999 having stopped the gabapentin after his prescription ran out in 1996, reporting the pain returned immediately. Again gabapentin was prescribed and at 900 mg three times daily he has been pain free for 12 months.
Graff-Radford
S B
SB
The Pain Center of Cedars-Sinai Medical Center and UCLA School of Dentistry, Los Angeles, CA, USA.
D000085:Acetates / Q000627:therapeutic use*; D000588:Amines; D000700:Analgesics / Q000627:therapeutic use*; D003229:Conjunctival Diseases / Q000188:drug therapy*; D003509:Cyclohexanecarboxylic Acids; D000077206:Gabapentin; D006261:Headache / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000503:physiopathology; D009668:Nose Diseases / Q000188:drug therapy*; D019233:Retreatment; D013546:Sweating / Q000187:drug effects*; D013577:Syndrome; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin