Abstract
The International Classification of Headache Disorders, 3rd edition (ICHD3) defines Short-lasting Unilateral Neuralgiform Headache Attacks (SUNHA) as attacks of moderate or severe, strictly unilateral head pain lasting from seconds to minutes, occurring at least once a day and usually associated with prominent lacrimation and redness of the ipsilateral eye. Two subtypes of SUNHA are identified: Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing (SUNCT) and Short-lasting Unilateral Neuralgiform headache attacks with cranial Autonomic symptoms (SUNA). These pathologies are infrequent in children and difficult to diagnose. The authors reviewed the existing literature on SUNCT and SUNA, especially in the developmental age, which describes the pathophysiology in detail and focuses on the therapeutic options available to date. SUNHA-type headaches must be considered on the one hand, for the possibility of the onset of forms secondary to underlying pathologies even of a neoplastic nature, and on the other hand, for the negative impact they can have on an individual’s quality of life, particularly in young patients. Until now, published cases suggest that no chronic variants occur in childhood and adolescents. In light of this evidence, the authors offer a review that may serve as a source to be drawn upon in the implementation of suitable treatments in children and adolescents suffering from these headaches, focusing on therapies that are non-invasive and as risk-free as possible for pediatric patients.
Highlights
According to the third edition of the International Classification of Headache Disorders (ICHD-3), Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing (SUNCT) and Short-lasting Unilateral Neuralgiform headache attacks with cranial Autonomic symptoms (SUNA), collectively known as Short-lasting Unilateral Neuralgiform Headache Attacks (SUNHA), are rare primary headache syndromes, which belong to the group of Trigeminal Autonomic Cephalalgias (TACs) [1]
Regardless, performing a full neuroradiological investigation with brain MRI is widely recommended in all cases of TACs/SUNHA, even in patients who exhibit typical clinical features and no neurological deficits, since the clinical phenotype of secondary TACs is indistinguishable from the primary forms [4,7,10,15,18,19,20,21]
According to the ICHD-3, SUNCT and SUNA can be further subdivided into episodic or chronic forms, which are characterized by attacks occurring for more than 1 year without remission or with remissions lasting less than three months [7] (Table 3)
Summary
According to the third edition of the International Classification of Headache Disorders (ICHD-3), Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing (SUNCT) and Short-lasting Unilateral Neuralgiform headache attacks with cranial Autonomic symptoms (SUNA), collectively known as Short-lasting Unilateral Neuralgiform Headache Attacks (SUNHA), are rare primary headache syndromes, which belong to the group of Trigeminal Autonomic Cephalalgias (TACs) [1]. The ICHD-3 defines SUNHA headaches as “attacks of moderate or severe, strictly unilateral head pain lasting from seconds to minutes, occurring at least once a day and usually associated with prominent lacrimation and redness of the ipsilateral eye” [1]. The difference between SUNCT and SUNA lies in the local autonomic signs accompanying the attacks: both ipsilateral conjunctival injection and tearing characterize SUNCT, while either one or the other, along. The difference between SUNCT and SUNA lies in the local autonomic signs accompanying t2hoef a12ttacks: both ipsilateral conjunctival injection and tearing characterize SUNCT, while either wointeh ootrhethr ecraonthiaelr,auatloonnogmwicitshignotsh, earppceraarnsiainl SauUtNonAo[m1–ic9]s. EInndkeeeedt, aal.re[c1e1n] thpigahpleigr hbtyedGrtoheant kuenedtiaagl.n[o1s1e]dhiSgUhNligHhAtedmtahyatleuanddipaagtnieonstesd tSoUuNnHdeArgmoauynlneeacdepssaatrieynptsrotoceudnudreersg, osuucnhneacsemssiasrgyupidroecdeddeunretas,l sturecahtmasemnti,sgwuiitdhendodpeanitnal rterseoaltumtieonnt,awndithexnpoopsuairne rteosloelnugtitohny aanndd ecxopstolsyutrreeatotmleenngtsthays awnedllcaossttlhyetpreeartsmisetenntst raisskwoefll aadsvtherespeeervsiesntetsn.t Trihske oaifmadovfetrhsee epvreensetsn.tTrheevaieimw oisf tthoegpartehseernetvriedveienwceisfrtoomgatthheerlietevriadteunrcee ofnrotmhethsiegnliitfiercaatnutrfeeoatnutrhese osfigannidfictahnetrafepaetuutriecsoopftiaonnds ftohrerSaUpNeuHtiAc oaptttihoensdfeovrelSoUpNmHenAtaalt atghee idneovredloepr mtoepnrtoavl aidgee uinseofrudl ecrlitnoicparloivnifdoermuasetifounl,cgliinviecnalthinefopromssaitbiloeni,mgpivaecnt othf ea pmoissssiebdle dimiagpnacotsiosfuapmonissthede qduiaaglintyosoifs luifpeoonf tahffeeqctueadliptyatoiefnlitfse.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
