Department of Neurology, Cincinnati Children Hospital Medical Center, University of Cincinnati, College of Medicine, Cincinnati, OH, USA.
Cephalalgia. 2021 Jan;41(1):112-116. doi: 10.1177/0333102420954525. Epub 2020 Aug 31.
Trigeminal autonomic cephalalgias (TACs) are characterized by paroxysmal attacks of unilateral primary headaches associated with ipsilateral craniofacial autonomic symptoms. In this pediatric case series, 13 cases of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)/short-lasting unilateral neuralgiform headache with autonomic symptoms (SUNA), including children ages 3-18 years, are discussed. This paper reviews the application of International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria especially in children presenting with SUNCT or SUNA. This is the largest pediatric case series of SUNCT/SUNA reported in the literature.
Trigeminal autonomic cephalalgias are rare in children and adolescents, with SUNCT/SUNA having the least reported cases. We will discuss the application of ICHD-3 criteria to diagnose SUNCT/SUNA in children and review overlapping cases and their response to different treatment options including indomethacin, which is typically reserved for specific subtypes of TACs; for example, paroxysmal hemicrania.
This case series presents a unique opportunity to aid in the diagnosis and treatment of similar pediatric cases in the future. It helps us to broaden the ICHD-3 criteria to diagnose and treat different overlapping trigeminal autonomic cephalalgia cases in children.
三叉自主神经性头痛（TAC）的特征是单侧原发性头痛发作伴有同侧颅面自主神经症状。在本儿科病例系列中，讨论了 13 例年龄在 3-18 岁的短暂单侧神经痛样头痛发作伴结膜充血和流泪（SUNCT）/短暂单侧神经痛伴自主神经症状（SUNA）。本文回顾了国际头痛疾病分类，第 3 版（ICHD-3）标准的应用，特别是在出现 SUNCT 或 SUNA 的儿童中。这是文献中报告的最大儿科 SUNCT/SUNA 病例系列。
三叉自主神经性头痛在儿童和青少年中较为罕见，SUNCT/SUNA 的报告病例最少。我们将讨论 ICHD-3 标准在诊断儿童 SUNCT/SUNA 中的应用，并回顾重叠病例及其对不同治疗方案的反应，包括吲哚美辛，吲哚美辛通常保留用于特定类型的 TAC，例如阵发性偏头痛。
本病例系列为未来类似儿科病例的诊断和治疗提供了独特的机会。它帮助我们拓宽了 ICHD-3 标准，以诊断和治疗儿童中不同的重叠三叉自主神经性头痛病例。
