Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms in NMOSD.

Abstract

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune demyelinating disorder of the CNS that frequently affects brainstem functions.1 Trigeminal neuralgia occurs in 2.5% of patients with NMOSD1; however, the occurrence of trigeminal autonomic cephalalgia (TAC) is rarely reported.2,3 Here, we describe a case of NMOSD with anti–aquaporin-4 (AQP4) antibodies who had a relapse with brainstem and cervical spinal cord lesions manifesting as short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA), a rare form of TAC.