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The syndrome of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a trigeminal autonomic cephalalgia. It is marked by multiple daily episodes of headache each lasting less than 250 seconds and accompanied by autonomic features. SUNCT is recognized as a treatment refractory headache, but there has been some success with lamotrigine,1 gabapentin,2 and topiramate.3 The etiology of SUNCT is unknown but neuroimaging has indicated a hypothalamic influence.4 SUNCT also occurs in individuals with pituitary tumors suggesting involvement of the hypothalamic-pituitary axis. A recent study suggested that SUNCT arises only in patients with acromegaly or with prolactinomas.5 Thus, growth hormone or dopamine or both may play a role in SUNCT pathogenesis. There are no reports of the course of SUNCT after pituitary tumor removal and normalization of pituitary hormones.
Case report.
A 37-year-old man presented with a 4-year history of daily left-sided retro-orbital headaches. Each headache would last 60 to 120 seconds, would occur …
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