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

A 45-year-old warehouse supervisor reports a headache attack that had woken him overnight. He describes severe pain over the cheek and jaw on one side of the head, distinctly different from the typical brow-and-eye pattern he had read about online, occurring as an isolated stab of pain rather than a run of jabs. While the pain was at its worst, the eye on the same side became bloodshot and watered continuously. Each episode lasts roughly eight minutes before resolving completely, and he currently notices three such attacks a day, clustering mainly around mealtimes. By his own estimate he has now had at least twenty-two of these attacks since they started a few weeks ago. He denies any weakness, slurred speech, or neck stiffness, and reports no history of head injury.