Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A Japanese SUNCT patient responsive to gabapentin

Yasuhiro Ito, M.D., Ph.D., Kazunori Imai, M.D., Junichiro Suzuki, M.D., Suguru Nishida, M.D., Takashi Kato, M.D. and Takeshi Yasuda, M.D., Ph.D.

Department of Neurology, TOYOTA Memorial Hospital

We report a Japanese patient with short lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUCNT) responsive to gabapentin. A 29-year-old man presented with sudden-onset intermittent left-sided orbital headache, which was not accompanied by lacrimation and conjunctival injection. We diagnosed trigeminal neuralgia at first and administered carbamazepine and loxoprofen. However, these medications were entirely ineffective at all and 6 days later, autonomic symptoms including conjunctival injection and tearing appeared. Diagnosis of SUNCT was made and gabapentin was started at up to 800 mg per day. Soon after, the headache and autonomic symptoms disappeared. Gabapantin at 800 mg per day was continued for 3 months and then reduced to 400 mg per day. Soon he had only a slight headache without tearing and conjunctival injection. He has continued to take gabapenin at 400 mg per day until now. This case indicated that headache and autonomic symptoms in SUNCT did not always emerge simultaneously, but they sometimes appear with time lag. Furthermore, the long-term clinical course and therapeutic outcome in SUNCT remain unknown. A therapeutic strategy and optimal dosage of medications including gabapentin should be established for the treatment of SUNCT.
Full Text of this Article in Japanese PDF (321K)

(CLINICA NEUROL, 51: 275|278, 2011)
key words: SUNCT, trigeminal neuralgia, autonomic symptom, gabapentin

(Received: 1-Nov-10)