Trigeminal Autonomic Cephalalgias

• Published in: Neurologic clinics Vol. 37; no. 4; pp. 847 - 869
• Main Authors: Burish, Mark J., MD, PhD, Rozen, Todd D., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2019
• Subjects: Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; Cluster headache; Diagnosis, Differential; Headache - diagnosis; Headache - drug therapy; Headache - physiopathology; Hemicrania continua; Humans; Hypothalamus - drug effects; Hypothalamus - physiopathology; Indomethacin - administration & dosage; Lithium Carbonate - administration & dosage; Melatonin - administration & dosage; Neurology; Paroxysmal hemicrania; SUNA; SUNCT; Trigeminal autonomic cephalalgia; Trigeminal Autonomic Cephalalgias - diagnosis; Trigeminal Autonomic Cephalalgias - drug therapy; Trigeminal Autonomic Cephalalgias - physiopathology; Vagus Nerve - drug effects; Vagus Nerve - physiopathology; Cluster headache; SUNA; Trigeminal autonomic cephalalgia; SUNCT; Paroxysmal hemicrania; Hemicrania continua
• ISSN: 0733-8619; 1557-9875
• DOI: 10.1016/j.ncl.2019.07.001

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.