Do trigeminal autonomic cephalalgias represent primary diagnoses or points on a continuum?

Curr Pain Headache Rep. 2015 Jun;19(6):22. doi: 10.1007/s11916-015-0493-0.

Abstract

The question of whether the trigeminal autonomic cephalalgias (TACs) represent primary diagnoses or points on a continuum has been debatable for a number of years. Patients with TACs may present with similar clinical characteristics, and occasionally, TACS respond to similar treatments. Prima facie, these disorders may seem to be intimately related. However, due to the current evidence, it would be challenging to accurately conclude whether they represent different primary headache diagnoses or the same primary headache disorder represented by different points on the same continuum. Ultimately, the TACs may utilize similar pathways and activate nociceptive responses that result in similar clinical phenotypes but "original and initiating" etiology may differ, and these disorders may not be points on the same continuum. This paper seeks to provide a brief comparison of TACs via diagnostic criteria, secondary causes, brief overview of pathophysiology, and the use of some key treatments and their mechanism of actions to illustrate the TAC similarities and differences.

Publication types

  • Review

MeSH terms

  • Autonomic Nervous System / physiopathology*
  • Diagnosis, Differential
  • Functional Laterality
  • Humans
  • Paroxysmal Hemicrania / diagnosis
  • Paroxysmal Hemicrania / physiopathology*
  • Trigeminal Autonomic Cephalalgias / diagnosis
  • Trigeminal Autonomic Cephalalgias / physiopathology*