Intractable SUNCT cured after resection of a pituitary microadenoma

Elizabeth Leroux, Todd J. Schwedt, David F. Black, David W. Dodick

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: SUNCT is a rare primary headache disorder that is associated with activation of the posterior hypothalamus and often poorly responsive to medication. Recently, a relationship between between pituitary microadenoma and SUNCT has been suggested, and reports of both amelioration and exacerbation by dopamine-agonists have been published. These findings suggest a functional role for the hypothalamic-pituitary axis in SUNCT. Methods: We report the long-term 4 year follow-up of a 35 year-old patient with a 14-year history of medically and surgically intractable SUNCT who experienced immediate and complete resolution of symptoms after resection of a 6 mm pituitary microadenoma. Results: This patient was first seen at the age of 28 years with a 10-year history of attacks of right retro-orbital pain satisfying the IHS criteria for SUNCT. Many medical and surgical treatments were attempted without success. An MRI demonstrated a 6 mm microadenoma without compression of surrounding structures. A trial of bromocriptine caused marked exacerbation of his pain. The patient underwent a trans-sphenoidal resection of the pituitary lesion. SUNCT attacks worsened for the first 24h post-operatively, then disappeared. He has been completely headache-free, without medication, for the past 43 months with the last follow-up being January 2006. Conclusion: This case emphasizes the relationship between pituitary microadenomas and SUNCT, supports the role of the hypothalamic-pituitary axis in the genesis of SUNCT, and illustrates the importance of careful imaging of the pituitary region in patients with SUNCT.

Original languageEnglish (US)
Pages (from-to)411-413
Number of pages3
JournalCanadian Journal of Neurological Sciences
Issue number4
StatePublished - Nov 2006

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


Dive into the research topics of 'Intractable SUNCT cured after resection of a pituitary microadenoma'. Together they form a unique fingerprint.

Cite this