SUNA

Short-lasting unilateral neuralgiform headaches with conjunctival injection (red eye) and tearing (SUNCT) and short-lasting unilateral neuralgiform headaches with autonomic symptoms (SUNA) are the same condition but characterised by slightly different symptoms associated with the headache attacks. SUNA is characterised by very short-lasting severe attacks of head or facial pain lasting between few seconds to 5-10 minutes, occurring between a few times a day to hundreds of times per day. The attacks can occur spontaneously or can be triggered by stimulation of the skin on the side of the pain such as touching, eating, talking, brushing, cold wind blowing on the face. The painful attacks are described often as stabbing, shooting and they are associated with typical facial symptoms namely eye watering, eye redness, runny nose or stuffy nose. SUNA can be caused by underlying abnormalities so require investigations. Treatment is with nerve stabilising drugs such as lamotrigine, though injectable treatments and surgical options are available for difficult to treat cases.