3.3.1 Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)

A 63-year-old retired librarian reports recurring bouts of headache that have troubled her for several months. Each attack is one-sided, centred over the temple, and she describes the pain as moderate rather than crippling. She says the discomfort rises and falls in an uneven zigzag rhythm within a single spell rather than staying level throughout. The attacks themselves last only around two minutes before fading, but while they are underway her eye on the affected side shows conjunctival redness and becomes watery, and the eyelid droops noticeably. Currently she experiences these episodes twice a day, most often in the early morning, and by her own count she has now had twenty-one such attacks in total. She has not noticed any nausea and reports no change in her vision.