Trigeminal Autonomic Cephalalgias

Neurol Clin. 2019 Nov;37(4):847-869. doi: 10.1016/j.ncl.2019.07.001. Epub 2019 Aug 24.

Abstract

The trigeminal autonomic cephalalgias (TACs) are a group of primary headache syndromes all marked by unilateral headache and ipsilateral cranial autonomic features. The TACs include cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing, and hemicrania continua. Pathophysiology includes the trigeminal pain system, autonomic system, hypothalamus, and more recently an identified role for the vagus nerve. Diagnosis is made after looking at headache frequency, duration, and accompanying symptoms. Each TAC has its own unique treatment, which is discussed in depth.

Keywords: Cluster headache; Hemicrania continua; Paroxysmal hemicrania; SUNA; SUNCT; Trigeminal autonomic cephalalgia.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Diagnosis, Differential
  • Headache / diagnosis
  • Headache / drug therapy
  • Headache / physiopathology
  • Humans
  • Hypothalamus / drug effects
  • Hypothalamus / physiopathology
  • Indomethacin / administration & dosage
  • Lithium Carbonate / administration & dosage
  • Melatonin / administration & dosage
  • Trigeminal Autonomic Cephalalgias / diagnosis
  • Trigeminal Autonomic Cephalalgias / drug therapy*
  • Trigeminal Autonomic Cephalalgias / physiopathology*
  • Vagus Nerve / drug effects
  • Vagus Nerve / physiopathology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Lithium Carbonate
  • Melatonin
  • Indomethacin