3.3.2 Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA)

A 38-year-old hairdresser describes facial pain that initially raised concern about a sinus problem. On questioning, her pain comes as brief, isolated, needle-sharp jabs of moderate severity, felt deep within and around one eye socket, never crossing to the other side. She has noticed her upper lid on that side drooping a little whenever a jab occurs, but her eye never turns red and does not water. Each jab resolves within around two minutes, she is currently getting two a day, and estimates at least twenty-one since the problem began last year. She reports no nasal blockage, no numbness in her face, and no change in hearing.