ガバペンチンが奏効した結膜充血と流涙をともなう短時間持続性片側神経痛様頭痛発作の1例  [in Japanese] A Japanese SUNCT patient responsive to gabapentin  [in Japanese]

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Author(s)

Abstract

症例は29歳の男性である.左眼周囲の間欠的な頭痛で発症し,当初は自律神経症状がなく三叉神経痛と診断したが,6日後に流涙,結膜充血といった自律神経症状が出現し,結膜充血と流涙をともなう短時間持続性片側神経痛様頭痛発作(SUNCT)と診断した.ガバペンチンを開始し,800mg/日に増量したところ,頭痛発作と自律神経症状はすみやかに消退した.3カ月後に400mg/日に減量した時点で,僅かに頭痛発作が生じた.SUNCTでは頭痛が自律神経症状に先行して出現するばあいがあることが示唆された.SUNCTの長期経過や治療は未解決な点が多く,本邦での症例の蓄積と治療方針の確立が望まれる.<br>

We report a Japanese patient with short lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUCNT) responsive to gabapentin. A 29-year-old man presented with sudden-onset intermittent left-sided orbital headache, which was not accompanied by lacrimation and conjunctival injection. We diagnosed trigeminal neuralgia at first and administered carbamazepine and loxoprofen. However, these medications were entirely ineffective at all and 6 days later, autonomic symptoms including conjunctival injection and tearing appeared. Diagnosis of SUNCT was made and gabapentin was started at up to 800mg per day. Soon after, the headache and autonomic symptoms disappeared. Gabapantin at 800mg per day was continued for 3 months and then reduced to 400mg per day. Soon he had only a slight headache without tearing and conjunctival injection. He has continued to take gabapenin at 400mg per day until now. This case indicated that headache and autonomic symptoms in SUNCT did not always emerge simultaneously, but they sometimes appear with time lag. Furthermore, the long-term clinical course and therapeutic outcome in SUNCT remain unknown. A therapeutic strategy and optimal dosage of medications including gabapentin should be established for the treatment of SUNCT.<br>

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 51(4), 275-278, 2011-04-01

    Societas Neurologica Japonica

References:  20

Codes

  • NII Article ID (NAID)
    10031164008
  • NII NACSIS-CAT ID (NCID)
    AN00253207
  • Text Lang
    JPN
  • Article Type
    SHO
  • ISSN
    0009918X
  • NDL Article ID
    11081760
  • NDL Source Classification
    ZS31(科学技術--医学--精神神経科学)
  • NDL Call No.
    Z19-298
  • Data Source
    CJP  NDL  J-STAGE 
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