, Volume 11, Issue 2, p 179
Date: 16 Mar 2010

Temporal response to bupivacaine bilateral great occipital block in a patient with SUNCT syndrome

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Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) syndrome is an infrequent form of unilateral headache accompanied by cranial autonomic features [1]. The pain is severe, and the titrations of some of the drugs have to be slow to prevent side effects [2, 3]. We present a case of a patient with SUNCT syndrome who showed a temporal improvement of pain with bupivacaine greater occipital nerve (GON) block.

A 82-year-old woman was admitted because of recent onset of facial pain. Intense attacks of periocular left pain, lasting for 2 min, had started 3 days previously. She also experienced conjunctival injection and lacrimation during the attacks. She suffered from 10 to 20 attacks per day. The neurological examination was absolutely normal, except that touching the left forehead triggered the pain without any refractory period. In the emergency room, with the suspicion of trigeminal neuralgia, she was prescribed carbamazepine 600 mg daily for a we