3.3.1.2 Chronic SUNCT

A 39-year-old freelance photographer has had one-sided head pain for roughly a year. It settles in his jaw and cheek rather than near the eye, on the left only, and reaches a severe level almost immediately. It comes as a rapid volley of jabbing stabs rather than a single jolt, with each attack lasting close to two minutes. During an attack the eye on that side reddens and waters, and the pupil narrows to a pinpoint. He has about two attacks on a normal day, and across the whole year he counts the total at close to 700. Over the past twelve months, he has never had a break from attacks longer than about three months.