A 17-year-old male patient presented with recurrent painful access due to pulsatile hemicrania, frontal and retro-orbital uveal pain and homo-lateral productive phenomena.
The episodes were of short duration (45 seconds to 5 minutes), repeated, sub-intrating, delayed the patient and significantly deteriorated their daily activity and wakefulness.
Occasionally they were accompanied by vomiting.
At the time of admission to our service, this condition had a 6-week evolution; analgesic and anti-migranosus treatment had been totally ineffective.
Intercritical neurological deficit was normal.
Normal otorhinolaryngological value.
Psychodiagnosis and personality profile with no remarkable elements.
Neuroimaging (MRI/angiographic MRI) was normal.
Indomethacin was used with very poor results.
Quality of life indicators and the headache calendar showed a significant deterioration.
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It was then decided to use some of the drugs that fulfill a role of membrane receptors, such as the relatively new antiepileptic drug group (AED), among which stabilized therapy (MPT) was chosen).
This decision took into account reports on efficacy in the treatment of SUNCT8 and its better biosafety profile for the other agents (gaba, lamotrigine).
It was started with 25 mg/d in a single night dose until reaching 75 mg/d with the same posology.
The introduction of the MPT in the scheme resulted in a significant partial reduction (50-75%, not complete) of the episodes, with an evident improvement in the quality of life of the patient documented by the MIDAS, an instrument that was specifically developed to assess the overall commitment.
