Short-duration unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is reported in a 5-year-old boy treated at Children Hospital Queen Fabiola, Brussels, Belgium. Episodes occurred 4 to 6 times over an hour every 2 to 3 days, they lasted a few seconds, without precipitating factor, never disturbing sleep, and were associated with nasal congestion. Neurologic exam including visual fields, fundi and MRI were normal. Frequency of attacks began to decrease after 3 months, without treatment, and headaches stopped spontaneously at 5 months after onset, with no recurrence at 1-year follow-up. [1]

COMMENT. Usually restricted to adults, this is the third case of SUNCT in a child, 2 previous cases in children aged 10 and 11 years, one idiopathic and the other secondary to astrocytoma in the ipsilateral pontocerebellar angle. In the idiopathic case, multiple trials of NSAIDs were unsuccessful. SUNCT is classified in the ICHD as a trigeminal autonomic cephalgia, along with cluster headache and paroxysmal hemicrania headache.