Crises de cefaleia neuralgiforme unilateral de curta duração: relatos de casos e revisão
DOI:
https://doi.org/10.48208/HeadacheMed.2025.22Palavras-chave:
SUNCT, SUNA, Cefaléias trigeminal-autonômicas, Diagnóstico de dor de cabeça, Sintomas autonômicos cranianosResumo
Introdução
As crises de cefaleia neuralgiforme unilateral de curta duração são o tipo mais raro de cefaleias trigêmino-autonômicas (CTAs), geralmente classificadas em dois subtipos: SUNCT (cefaleia neuralgiforme unilateral de curta duração com injeção conjuntival e lacrimejamento) e SUNA (com sintomas autonômicos cranianos). Esses distúrbios caracterizam-se por crises breves de dor unilateral acompanhadas de sintomas parassimpáticos cranianos, podendo ser de difícil diagnóstico e manejo na prática clínica.
Objetivo
Apresentar dois casos clínicos de SUNCT e realizar uma revisão abrangente dos critérios diagnósticos atuais, da fisiopatologia e das opções terapêuticas, destacando as diferenças entre SUNCT/SUNA e outras síndromes de cefaleia.
Métodos
Descrevemos dois pacientes diagnosticados com SUNCT em nosso ambulatório de cefaleias. Foi realizada uma revisão da literatura com foco em características clínicas, critérios diagnósticos da International Classification of Headache Disorders (ICHD-3), mecanismos fisiopatológicos propostos e estratégias terapêuticas disponíveis.
Resultados
Ambos os pacientes apresentaram múltiplas crises diárias de dor unilateral, de curta duração, acompanhadas de sintomas autonômicos cranianos. A investigação diagnóstica descartou causas secundárias. O quadro clínico correspondeu aos critérios de SUNCT definidos pela ICHD-3. As abordagens terapêuticas variaram e incluíram intervenções farmacológicas com alívio parcial dos sintomas. A revisão evidencia os desafios em diferenciar SUNCT/SUNA de outros distúrbios de cefaleia, como a neuralgia do trigêmeo e a cefaleia em salvas.
Conclusão
O reconhecimento preciso de SUNCT/SUNA é essencial para o manejo adequado, já que diagnósticos incorretos são comuns devido à sobreposição de sintomas com outras síndromes de cefaleia. Maior conscientização e compreensão dessas condições raras podem levar a diagnósticos mais assertivos, tratamentos direcionados e melhores desfechos para os pacientes.
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Copyright (c) 2025 André Luiz Vieira Lockmann, Iasmim Portela Maifrede, Mauro Eduardo Jurno, Luiz Paulo Bastos Vasconcelos (Author)
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
