Botulinum Toxin A for the Treatment of a Child with SUNCT Syndrome

Yi Zhang,Ya-Jun Lian,Lu Zhang,Nan-Chang Xie,Xuan Cheng,Haifeng Zhang,Yun-Qing Ma

doi:10.1155/2016/8016065

Abstract

Background. Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome is an unusual cause of headache, mainly described in older adults, and is rare in children. Pain attacks may be severe, frequent, and prolonged. The therapeutic benefits of many drugs are disappointing. Patient and Methods. A 12-year-old boy suffered severe headache and toothache for 20 days. As treatment with nonsteroidal anti-inflammatory drugs, anticonvulsants, and steroids proved ineffective, he was treated with ipsilateral multisite subcutaneous injections of botulinum toxin A 70 U around the orbit, the temporal area, and the upper gum. Results. The pain had reduced in frequency and severity by the fourth day after treatment and had completely disappeared after 7 days. There were no side effects or recurrence during a subsequent 17-month follow-up period. Conclusion. Botulinum toxin A can be used to treat the first episode of SUNCT in children over the age of 12 years.

Highlights

BackgroundShort-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome is an unusual cause of headache, mainly described in older adults, and is rare in children
Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome is an unusual cause of headache and is mainly found in middle aged or older patients
The clinical features of SUNCT syndrome are a transient onset of severe unilateral orbital pain, accompanied by ipsilateral conjunctival injection and tearing

Summary

Background

Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome is an unusual cause of headache, mainly described in older adults, and is rare in children. Pain attacks may be severe, frequent, and prolonged. The therapeutic benefits of many drugs are disappointing. A 12-year-old boy suffered severe headache and toothache for 20 days. As treatment with nonsteroidal anti-inflammatory drugs, anticonvulsants, and steroids proved ineffective, he was treated with ipsilateral multisite subcutaneous injections of botulinum toxin A 70 U around the orbit, the temporal area, and the upper gum. The pain had reduced in frequency and severity by the fourth day after treatment and had completely disappeared after 7 days. Botulinum toxin A can be used to treat the first episode of SUNCT in children over the age of 12 years

Introduction

Patient and Methods

Findings

Discussion