Rhinolith–A Rare Cause of Sunct Syndrome: A Case Report

JOURNAL TITLE: Journal on Recent Advances in Pain

Author
1. Ekta Agarwal
2. Charu Singh
3. Sachin Khanduri
4. Rohit Gupta
5. Mohd. Shakeel
6. Anuja Bhargava
7. Zeba Siddiqi
ISSN
2454-6607
DOI
10.5005/jp-journals-10046-0107
Volume
4
Issue
2
Publishing Year
2018
Pages
2
Author Affiliations
    1. Department of Otorhinolaryngology, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
    1. Department of Radiology, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
    1. Department of ENT, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
    1. Department of ENT and Head and Neck Surgery, Eras Lucknow Medical College and Hospital Lucknow, Uttar Pradesh, India
    1. Department of ENT, Eras Lucknow Medical College and Hospital Lucknow, Uttar Pradesh, India
    1. Department of Medicine, Eras Lucknow Medical College and Hospital Lucknow, Uttar Pradesh, India
  • Article keywords
    Headache, Rhinolith, Sunct syndrome

    Abstract

    Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare cause of unilateral headaches affecting predominantly males in usually the fifth decade. The pain is usually moderate to severe in intensity affecting the ocular and the periocular area. The mean duration of paroxysms is 1 minute, with a range of 5 to 250 seconds. A 25-year-old male complained of progressive unilateral left nasal obstruction for 8 months along with ipsilateral daytime headache predominantly in the periocular and temporal region, conjunctival injection, tearing and minimal eyelid edema. The patient was admitted and kept under observation for the reported symptoms. Nasal endoscopy and probing revealed a greenish/ dirty grey and gritty mass filling posterior part of the left nasal cavity at the time of a headache, there was right sided ipsilateral congestion in the conjunctiva, lacrimation minimal and periorbital edema neurological examination of the patient was normal. The patient was posted for endoscopic rhinolith removal followed by infundibulotomy and maxillary sinusotomy. At 3 week follow-up, the patient was relieved of all symptoms and required no medication. The patient was asymptomatic at 6 week and 6 months follow up. Thus a diagnosis of secondary SUNCT cause rhinolith was confirmed which resolved with rhinolith removal.

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