Microvascular decompression may be effective for refractory SUNCT regardless of symptom duration

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome is characterized by short-lived (5–240 s), strictly unilateral, periorbital, severe pain attacks, accompanied by ipsilateral conjunctival injection and lacrimation.

SUNCT syndrome has been considered to be refractory to treatment, although recent small case series have suggested benefit from different antiepileptic drugs. In some cases surgical intervention may be advocated, particularly when the pain is medically intractable or the medications are not tolerated.

We present a patient with chronic SUNCT syndrome who was successfully treated with posterior fossa vascular decompression 19 years after the onset of symptoms.

CITATION Cephalalgia. 2010 May;30(5):626-30