What is a SUNCT headache?
SUNCT (Short-lasting, Unilateral, Neuralgiform headache attacks with Conjunctival injection and Tearing) is a rare headache disorder characterized by short, intense headaches on one side of the face, with burning, stabbing, or throbbing pain around the eye or temple. SUNCT headaches, also known as SUNCT syndrome or unilateral headaches, primarily impact people over the age of 50 who were assigned male at birth. SUNCT headache belongs to a group of disorders called trigeminal autonomic cephalgias (TACs), headaches characterized by a similarly described pain on one side of the face or head.
While there is no cure for SUNCT headaches, they are not life-threatening. The persistent nature of SUNCT episodes can impact your quality of life, making it important to seek treatment by an experienced provider. Neurologists at Penn Medicine specialize in treatment and management options for the full range of headaches, including SUNCT.
Symptoms of SUNCT headaches
Symptoms of SUNCT headache include frequent and intense episodes of pain that last from seconds to a few minutes. These episodes typically occur around one eye and temple, and are often described as burning, stabbing, or throbbing.
People with SUNCT headache often experience multiple episodes per hour during the daytime. Alongside the pain, patients may experience autonomic symptoms, or symptoms that occur without consciously controlling them, including:
- Eyelid swelling
- Forehead sweating
- Increased pressure in the affected eye
- Nasal congestion
- Watery eyes
Your systolic blood pressure may also rise during these episodes.
SUNCT syndrome causes
The exact cause of SUNCT headaches is unclear and not typically associated with any specific underlying condition. In some cases, lesions, cysts, or tumors in the brain may contribute to the onset of a SUNCT headache. Other potential causes linked to SUNCT include:
- Abnormalities in brain arteries
- Neurofibromatosis (a genetic disorder that leads to nerve-related tumors)
- Strokes affecting the brain stem
- Tears in the vertebral artery
- Trauma to the eye area
- HIV (in rare instances)
SUNCT headache pain episodes may be spontaneous or triggered by activities like touching the forehead or eye area, chewing, facial expressions, or neck movements. SUNCT may also be caused by disturbances in specific brain regions, possibly affecting the trigeminal nerve. Researchers in Penn Medicine’s Headache Program continue working to better understand what causes SUNCT syndrome and other headache disorders.
Diagnosing SUNCT
SUNCT headaches are diagnosed based on a patient’s reported symptoms. It's important that you take note of your symptoms and how often you feel them. A diagnosis is usually made when a patient experiences at least 20 episodes of pulsating or stabbing pain. Your doctor will check with you to confirm that these episodes are occurring around one eye, under the eye, or in the temple area and whether they last from one to 10 minutes. Your doctor will also check to see if you are experiencing conjunctival injection (eye redness) or lacrimation (teary eyes), two symptoms that typically begin when pain episodes end.
SUNCT headache treatment
Treating SUNCT headaches can be a challenging task as they often don’t respond well to standard therapies used for short-lasting headaches. These headaches have a unique pattern of occurrence and are unpredictable, which makes it difficult for doctors to manage them effectively and assess whether treatments are working. Medications can be helpful in relieving the pain. Additional treatment options are available and, with the right care team, it’s possible to find relief from SUNCT headache symptoms.
Get expert treatment at Penn Medicine
Penn Medicine is an excellent choice for those seeking treatment for SUNCT headaches and other TACs. Our headache and migraine care program is led by a team of experienced neurologists, clinical psychologists, physical and occupational therapists, and experts in sleep medicine, nutrition, and holistic therapies. They specialize in the accurate diagnosis and treatment of various headache disorders in adults including SUNCT, SUNA (Short-lasting Unilateral Neuralgiform headache with Autonomic symptoms) and other TACs, migraines, tension-type headaches, cluster headaches, chronic daily headaches, and facial pain disorders. When you come to Penn Medicine, we’ll identify the most effective strategies to eliminate or manage your headaches effectively, so you can get back to living your life.