Abstract text (incl. figure legends and references)

Background: Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA), collectively known as short-lasting unilateral neuralgiform headache attacks (SUNHA), has hitherto not been studied sufficiently due to limited data, particularly in China. This study aimed to characterize and compare SUNCT and SUNA, as well as to aid in the identification of appropriate diagnostic and therapeutic strategies.

Methods: Between April 2009 and December 2021, individuals visiting a tertiary headache center or seven other headache clinics in China who were diagnosed with SUNCT or SUNA were included, compared its demographics and clinical characteristics.

Results: In total, 45 individuals with SUNCT and 31 individuals with SUNA were included in the study. SUNCT had a mean onset age of 37.22 ± 14.54 years while SUNA had a mean onset age of 42.45 ± 14.72 years. Both SUNCT and SUNA had a female preponderance (M:F 1:1.14 vs 1:2.10). Headache severity was moderate or severe[m1] . Qualitative descriptions of attacks were stabbing pain (44.7%), electric shock-like pain (36.8%), shooting pain (25.0%), and slashing pain (18.4%). Two individuals had an attack duration of more than 600 sec, and two had a self-reported duration of less than 1 second. No significant variations in demographic or clinical parameters were detected between the two, except for attack areas (temporal area in SUNCT, p = 0.017; parietal area in SUNA, p = 0.002).

Conclusions: SUNCT and SUNA should be classed as a single clinical entity, however this will require more research.