SynthesisJournal of neurology, neurosurgery, and psychiatry2021
Medical treatment of SUNCT and SUNA: a prospective open-label study including single-arm meta-analysis.
Synthesis in Journal of neurology, neurosurgery, and psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Slow-inactivated sodium channels as a therapeutic target in trigeminal neuralgia: evidence from a systematic review and meta-analysis of lacosamide.Journal of oral & facial pain and headache · 2026Pooled it
- Practice advisory for intravenous management of headache disorders in hospitalized patients: a review of the evidence and consensus recommendations.Regional anesthesia and pain medicine · 2026Pooled it
- Efficacy and safety of lacosamide in patients with trigeminal neuralgia: an 8-week pilot dose-escalation study.Journal of oral & facial pain and headache · 2025Trial
- Article
- Peripheral nerve blocks for primary and secondary headache disorders: review of current evidence and a practical approach.Journal of oral & facial pain and headache · 2026Review
- Hallmarks of primary headache: part 3 - cluster headache.The journal of headache and pain · 2025Review
- Bortezomib-induced peripheral neuropathy: from molecular mechanisms to clinical management.Frontiers in pharmacology · 2025Review
- Facial pain in MS: When to think of trigeminal autonomic cephalalgia.Multiple sclerosis (Houndmills, Basingstoke, England) · 2024Article
- Review
- Excellent Response to Repeated Greater Occipital Nerve Blocks in a Patient with Short-Lasting Unilateral Neuralgiform Headache with Conjunctival Tearing.Annals of Indian Academy of Neurology · 2024Article
- Sex differences in trigeminal neuralgia: a focus on radiological and clinical characteristics.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023Article
- A single infusion of intravenous lidocaine for primary headaches and trigeminal neuralgia: a retrospective analysis.Frontiers in neurology · 2023Article
- Similarities and differences between SUNCT and SUNA: a cross-sectional, multicentre study of 76 patients in China.The journal of headache and pain · 2022Article
- Trigeminal microvascular decompression for short-lasting unilateral neuralgiform headache attacks.Brain : a journal of neurology · 2022Article
- Central Nervous System Involvement of Multiple Myeloma Presenting as Short-lasting Unilateral Neuralgiform Headache with Conjunctival Injection and Tearing: A Case Report.The Neurohospitalist · 2022Article
- Article
- Trigeminal neuralgia: a practical guide.Practical neurology · 2021Review
- A Retrospective Comparative Study in Patients with SUNA and SUNCT.Annals of Indian Academy of NeurologyArticle
- SUNHA: A Mystifying Cephalgia.Annals of Indian Academy of NeurologyArticle
- Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe management of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) remains challenging in view of the paucity of data and evidence-based treatment recommendations are missing.
methodsIn this single-centre, non-randomised, prospective open-label study, we evaluated and compared the efficacy of oral and parenteral treatments for SUNCT and SUNA in a real-world setting. Additionally, single-arm meta-analyses of the available reports of SUNCT and SUNA treatments were conducted.
resultsThe study cohort comprised 161 patients. Most patients responded to lamotrigine (56%), followed by oxcarbazepine (46%), duloxetine (30%), carbamazepine (26%), topiramate (25%), pregabalin and gabapentin (10%). Mexiletine and lacosamide were effective in a meaningful proportion of patients but poorly tolerated. Intravenous lidocaine given for 7-10 days led to improvement in 90% of patients, whereas only 27% of patients responded to a greater occipital nerve block. No statistically significant differences in responders were observed between SUNCT and SUNA. In the meta-analysis of the pooled data, topiramate was found to be significantly more effective in SUNCT than SUNA patients. However, a higher proportion of SUNA than SUNCT was considered refractory to medications at the time of the topiramate trial, possibly explaining this isolated difference.
conclusionsWe propose a treatment algorithm for SUNCT and SUNA for clinical practice. The response to sodium channel blockers indicates a therapeutic overlap with trigeminal neuralgia, suggesting that sodium channels dysfunction may be a key pathophysiological hallmark in these disorders. Furthermore, the therapeutic similarities between SUNCT and SUNA further support the hypothesis that these conditions are variants of the same disorder.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.