SUNCT Like Facial Pain Successfully Treated with Kakkonto and Keishikajutsubuto : A Case Report

Abstract

A 76-year-old man presented with severe headache attacks with ptosis, running tears, and conjunctival redness of the eyelid appeared dozens of times daily, three weeks after the appearance of a skin rash caused by Varicella-zoster virus (VZV) in the first branch of the right trigeminal nerve area. The headache attacks demonstrated as short-lasting unilateral neuralgia-like headache attacks with conjunctival injection and tearing (SUNCT) like facial pain MRI. He was treated with valacyclovir for VZV and analgesics for severe headache attacks, but was refractory to analgesics or stellate ganglion block other than acetaminophen. Symptoms improved after treatment with kakkonto and keishikajutsubuto, which can be used for a beneficial alternative treatment for VZV associated SUNCT like facial pain.