title: [Paroxysmal hemicrania and SUNCT].
abstract: Paroxysmal hemicrania is experienced as headache attacks with pain and accompanying symptoms similar to those of cluster headaches. Attacks are, however of shorter duration, occur more frequently, affect predominantly women and respond reliably to indomethacin. Paroxysmal hemicrania can also occur secondary to an identifiable cause. To exclude symptomatic, paroxysmal hemicrania, especially with an atypical clinical picture and poor response to indomethacin, a careful diagnostic approach is necessary. The SUNCT syndrome (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) is characterized by one-sided pain attacks of short duration, much shorter than other trigeminal autonomic cephalgias. Classically, the pain is accompanied by ipsilateral lacrimation and conjunctival injection. Some patients have been described with both cluster headache and trigeminal neuralgia. These patients should receive both diagnoses. It is important to differentiate these headache entities as specific therapy is needed for each to achieve optimal pain relief.
authors: Migräne- und Kopfschmerzzentrum, Neurologisch-verhaltensmedizinische Schmerzklinik Kiel, Heikendorfer Weg 9-27, 24149, Kiel, Deutschland. hg@schmerzklinik.de
authors: H
authors: H
authors: Göbel
authors: C
authors: C
authors: Göbel
authors: A
authors: A
authors: Heinze
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D003027:Cluster Headache / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D008012:Lidocaine / Q000627:therapeutic use; D009460:Neurologic Examination; D010147:Pain Measurement; D051302:Paroxysmal Hemicrania / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D050798:SUNCT Syndrome / Q000175:diagnosis* / Q000209:etiology; D055502:Secondary Prevention; D014277:Trigeminal Neuralgia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
chemical_list: D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D008012:Lidocaine; D007213:Indomethacin