Delayed development of SUNCT in a patient with post-traumatic trigeminal neuropathic pain: clinical observation and current concepts

SUNCT (Shortlasting Unilateral Neuralgiform Headache Attacks (SUNHA) with Conjunctival Injection and Tearing) is considered a rare variant of primary trigeminal autonomic cephalgias, combining features of moderate or severe unilateral headache and autonomic symptoms on the ipsilateral side. A case of delayed development of SUNCT in a 76-year-old man who had suffered from post-traumatic trigeminal neuropathic pain for 2 years before is described. It is emphasized that in patients with post-traumatic trigeminal neuropathic pain, it is necessary to pay attention to a possible change in the pattern of headache and prosopalgia, the likelihood of the appearance of autonomic symptoms and delayed development of SUNCT. The article discusses modern concepts of post-traumatic trigeminal neuropathic pain, SUNCT and SUNHA, as well as differential diagnostic and therapeutic approaches to the management of this category of patients, using a clinical observation as an example.