A 34-year-old woman presented with new intermittent short lasing
headache around the left eye accompanied with lacrimation. She suffered from
anemia and visual disturbance due to thalassaemia beta heterotype and
retinitis pigmentosa. She also had continual
cephalalgia from about 9 years old, and was taking nonsteroidal anti-inflammatory
drug almost every day. After the medical treatment, we diagnosed her
headache as
migraine without aura,
medication overuse headache (MOH) and short lasting unilateral neuralgiform
headache attacks with cranial autonomic symptoms (SUNA).
Triptan was effective for a
migraine headache, but it was ineffective for attacks of SUNA, while
topiramate dramatically reduced the SUNA attacks. A
headache diary was effective to evaluate the
clinical course and the effect of treatment for two different types of
headaches by devising the approach to description. A
migraine and MOH may coexist with SUNA, and our attention should be paid to the diagnosis and medical treatment in such cases.