ABSTRACT
Short-lasting unilateral neuralgiform headache attacks with conjuntival injection and tearing (SUNCT) is considered a rare trigeminal autonomic cephalgias, a group of primary headache disorders characterized by brief episodes of severe unilateral headache in the distribution territory of the trigeminal nerve, accompanied by prominent ipsilateral and cranial parasympathetic autonomic features. The present report describes a SUNCT syndrome in a 64-year-old male who had been diagnosed with trigeminal neuralgia several years ago. The patient reported stabbing pain in the orbital zone and in the left upper maxillary region, of great intensity, brief duration, and a frequency of 20-100 attacks a day. Pain episodes were accompanied by conjunctival injection and tearing. Based on the anamnesis, clinical examination and a magnetic resonance imaging scan, episodic SUNCT syndrome was diagnosed and pharmacological treatment with topiramate was started. This reduced the intensity and number of attacks to 3-6 a day. Key words:Trigeminal autonomic cephalgias, SUNCT, Cluster headache, topiramate.
ABSTRACT
OBJECTIVES: To evaluate the efficacy of Oraqix(R) during scaling and root planing (SRP) in comparison with 20% benzocaine and placebo. Study DESIGN: 15 patients requiring 4 sessions of SRP were enrolled. For each patient, Oraqix(R), Hurricaine(R), vaseline or no anesthetic product were randomly assigned each to a quadrant. Treatment pain was evaluated on a 100 mm Visual Analog Scale (VAS) and on a Verbal Rating Scale (VRS). The amount of product administered, the need to re-anesthetise, patient and operator satisfaction and the onset of side-effects were also recorded. RESULTS: Oraqix(R) was significantly better than nothing, with a reduction of VAS score to 13.3 units, but without significant differences with Vaseline or Hurricaine(R). Oraqix(R) was better in VRS reduction than not using any anesthetic (p = 0.001) or using vaseline (p = 0.024), but similar to Hurricaine(R) (p = 0.232). CONCLUSIONS: Oraqix(R) effectively controls pain in SRP procedures, with few side-effects and a good acceptance on the part of patients and clinicians
