Abstract
Patient: A 69-year-old woman had experienced the paroxysmal pain around the left periorbital and temporal area approximately a month ago. Computed tomography（CT） and magnetic resonance imaging（MRI） of the head performed at the Neurosurgery clinic had revealed that there was no problem. Suspected of the pain caused by dental disease, she visited our hospital. The attack was electric pain （Visual Analogue Scale: 75） with autonomic symptoms, such as lacrimation, for few minutes about 10 times per day. We diagnosed possible trigeminal autonomic cephalalgias（TACs）, and she was prescribed Indometacin farnesyl （400mg/day） for 7 days. Subsequently, because the pain persisted, we excluded episodic paroxysmal hemicrania and diagnosed short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing（SUNCT） or short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms（SUNA）. At the Neurology, she was definitely diagnosed with SUNCT and prescribed Clonazepam and Gabapentin. Subsequently, the pain improved.
Discussion: SUNCT is TACs characterized by the paroxysmal pain around unilateral orbital, superior orbital, and temporal area with ipsilateral conjunctival injection and lacrimation. It is important for diagnosis of TACs type to evaluate the duration of the paroxysmal pain and the effect of Indometacin. It is recommended that general dentists should have knowledge of headache because headache patients such as TACs may visit a dental department. In particular, orofacial pain clinicians need to have knowledge to correctly diagnose TACs type.
Conclusions: We consider it is important that dentists have knowledge of headache.
