What should you know about SUNCT headache?

SUNCT stands for short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing. Attacks are usually felt around one eye or the temple, may arrive many times in a day, and can be triggered by touch, movement, heat, or bright light. The eye may become red and watery on the painful side, and the nose can feel blocked or runny. This pattern differs from a typical tension headache and needs a clinician to distinguish it from other one-sided headache disorders.

Arrange a medical assessment if these attacks are new, recurring, or changing. Record the start time, duration, side of pain, eye or nose changes, possible triggers, and any medicines taken. Do not repeatedly self-treat severe recurrent pain without advice. Headache during hot weather may also relate to dehydration or heat exhaustion; fever or respiratory symptoms may point to an infection such as a common cold or COVID-19.

Seek urgent help for a sudden explosive headache, new weakness or numbness, fainting, confusion, seizure, trouble speaking, loss of vision, a painful red eye, stiff neck with fever, or repeated vomiting. Get prompt assessment if the pattern is new, follows a head injury, occurs during pregnancy, or becomes steadily more severe.

Could this pattern be SUNCT or another one-sided headache disorder? Do I need an eye or neurological examination? What should I record during an attack, and which treatments are appropriate for prevention or acute symptoms?