SUNCT and SUNA Headaches

Trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders characterized by unilateral trigeminal distribution pain with ipsilateral cranial autonomic features. Types of TACs include cluster headache, paroxysmal hemicrania, hemicrania continua and short-lasting unilateral neuralgiform headache attacks. There are two subtypes of short-lasting unilateral neuralgiform headache attacks: Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA).
SUNCT and SUNA are both short-lasting, last 10 minutes or less. Both SUNCT and SUNA are unilateral or one sided. Both result in pain that feels “nerve like” or neuralgiform. Additional symptoms shared between the two headache conditions include conjunctival injection (redness of the eye) and tearing of the eye. Additionally, both SUNCT and SUNA are autonomic or involuntary.
The major difference between the two is that with SUNCT headaches, a patient will have both redness of the eyes and tearing of the eyes. With SUNA headaches, a patient will have either redness of the eyes or tearing of the eyes, but not both symptoms.
SUNCT and SUNA are often confused with primary stabbing headache or other TACs (cluster headache, paroxysmal hemicrania, hemicrania continua). What makes Primary Stabbing Headaches different is that they don’t involve the redness of the eyes, tears, nasal congestion, or runny nose. Cluster Headache attacks differ by lasting at least 15 minutes and can continue for up to three hours. Hemicrania Continua differ by lasting all day, with variable intensity. Paroxysmal Hemicrania attacks differ by lasting up to 30 minutes.
– Caroline Pruski, NP