SUNCT syndrome secondary to prolactinoma

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 74; no. 11; pp. 1590 - 1592
• Main Authors: Matharu, M S, Levy, M J, Merry, R T, Goadsby, P J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01-11-2003; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: ACTH; Adenoma - complications; Adenoma - diagnosis; Adenoma - pathology; adrenocorticotropic hormone; Adult; Biological and medical sciences; Carotid arteries; Conjunctival Diseases - etiology; Conjunctival Diseases - pathology; Diagnosis; Diagnosis, Differential; Dopamine; Endocrinopathies; Evaluation; fMRI; follicle stimulating hormone; FSH; functional magnetic resonance imaging; growth hormone; Headache; Headache - complications; Headache - etiology; Headaches; Humans; Hypothalamus. Hypophysis. Epiphysis (diseases); lutenising hormone; Magnetic Resonance Imaging; Male; Medical sciences; Neurologic manifestations of general diseases; NMR; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Nuclear magnetic resonance; Pain; Patients; Pituitary gland; pituitary neoplasm; Pituitary Neoplasms - complications; Pituitary Neoplasms - diagnosis; Pituitary Neoplasms - pathology; Prolactinoma; Prolactinoma - complications; Short Report; short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing; Sinuses; SUNCT; SUNCT syndrome; Syndrome; Tears - metabolism; Thyroid gland; thyroid stimulating hormone; TSH; Tumors; Veins & arteries; United Kingdom; Endocrinopathy; Human; SUNCT syndrome; Adenoma; Nuclear magnetic resonance imaging; Secretory tumor; Case study; Prolactinoma; Etiology; Pituitary diseases; Medical imagery; Pituitary gland; Benign neoplasm
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.74.11.1590

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome is a rare form of primary headache disorder, although secondary causes, particularly posterior fossa abnormalities, are well known. We report a case of SUNCT syndrome secondary to a prolactinoma. Administration of dopamine agonists led to complete resolution of the SUNCT attacks. This case, together with other similar case reports in the literature, highlight the importance of excluding a diagnosis of pituitary adenoma in all suspected cases of SUNCT syndrome, especially as the headache can precede more classical pituitary symptoms by a considerable period of time. Clinicians managing patients with suspected SUNCT syndrome should elicit a history of symptoms associated with pituitary neoplasms, perform a magnetic resonance imaging scan of the brain and pituitary, and screen for serum hormonal abnormalities.