Um caso raro de cefaleia neuralgiforme com sintomas autonómicos em idade pediátrica: desafios diagnósticos e abordagem multidisciplinar

Neuralgiform headache, though rare, presents a diagnosis challenge in paediatric patients. This case study describes a 13-year-old female who experienced intense, electric shock-like headaches for two months. The headaches were unilateral, triggered by cold water, and associated with autonomic symptoms such as tearing, nasal congestion, and ptosis. Given the patient’s clinical presentation, a diagnosis of short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms was proposed. Imaging tests revealed sinusitis and a dental periapical lesion. Surgical intervention and treatment with gabapentin along with clinical hypnosis resulted in significant pain relief, although not complete. This case underscores the importance of thorough investigation and multidisciplinary management in paediatric patients with complex headache presentations. The long-term prognosis is variable, warranting ongoing follow-up.