Advances in the diagnosis and treatment of short-lasting unilateral neuralgiform headache attacks
10.19845/j.cnki.zfysjjbzz.2025.0112
- VernacularTitle:短暂单侧神经痛样头痛发作的诊疗进展
- Author:
Qing DONG
1
;
Mingxin LI
1
Author Information
1. Department of Neurology，the Third Affiliated Hospital of Sun Yat-sen University，Guangzhou 510630，China
- Publication Type:Journal Article
- Keywords:
Short-lasting unilateral neuralgiform headache attacks;
Trigeminal autonomic cephalalgias;
Cranial autonomic symptoms;
Trigeminohypothalamic pathway
- From:
Journal of Apoplexy and Nervous Diseases
2025;42(7):588-593
- CountryChina
- Language:Chinese
-
Abstract:
Short-lasting unilateral neuralgiform headache attacks （SUNHA） are a rare type of disabling primary headache within the category of trigeminal autonomic cephalalgias （TACs）， and it has two subtypes of SUNCT （with conjunctival injection and tearing） and SUNA （with other autonomic features）. SUNHA is characterized by severe unilateral （often V1） stabbing/shock-like pain （lasting for 1-600 s）， high frequency （2‒600 attacks a day）， and prominent ipsilateral cranial autonomic symptoms （such as conjunctival injection，tearing， and nasal obstruction）. Trigger factors are observed in 86% of patients. The diagnosis of SUNHA should meet the ICHD-3 criteria （≥20 attacks）， and brain MRI （especially for the pituitary gland/posterior cranial fossa） should be performed to exclude secondary causes （such as neurovascular conflict and pituitary tumor）. Lamotrigine is used as first-line prophylaxis， while lidocaine aids acute relief in the transitional phase； occipital nerve stimulation， deep brain stimulation， or microvascular decompression can be used for refractory cases. It is of great importance to enhance awareness， achieve precise differentiation（from trigeminal neuralgia or other types of TACs）， and provide individualized treatment.
- Full text:2025081109445313976短暂单侧神经痛样头痛发作的诊疗进展.pdf
