BRAIN and NERVE－神経研究の進歩68巻8号

2016年08月発行

症例報告

微小血管減圧術が奏効した結膜充血と流涙を伴う難治性の短時間持続性片側神経痛様頭痛発作（SUNCT）の1例

著者： 菊井祥二¹ 宮原淳一¹ 杉山華子¹ 柏谷嘉宏¹ 竹島多賀夫¹

所属機関： ¹富永病院神経内科・頭痛センター

ページ範囲：P.951 - P.955

文献概要

43歳男性。右眼周囲の電撃痛で発症。4カ月後に同部位に充血，流涙，鼻漏を伴う1時間程度の鋸歯状の激痛が出現し，結膜充血と流涙を伴う短時間持続性片側神経痛様頭痛発作（SUNCT）と診断。診断の2カ月後に改善したが，6カ月後に再発した。ラモトリギンなど多くの抗てんかん薬に対して中毒疹がみられ，難治性と考えられた。頭部MRIで右三叉神経に神経血管圧迫（NVC）がみられ，微小血管減圧術（MVD）を施行。術後より痛みは寛解した。一部のSUNCTにはNVCの関与も推測され，難治例にはMVDの検討も必要である。

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