Pathophysiology of the trigeminal autonomic cephalalgias
- Arne May, MD
Arne May, MD
- Professor of Neurology, Department of Systems Neuroscience
- University Clinic Hamburg, Eppendorf (UKE)
- Anna S Cohen, MD
Anna S Cohen, MD
- Consultant Neurologist
- Royal Free Hospital, London
- Peter J Goadsby, MD, PhD
Peter J Goadsby, MD, PhD
- Professor of Neurology
- King's College London
- University of California, San Francisco
The trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders characterized by unilateral trigeminal distribution pain that occurs in association with prominent ipsilateral cranial autonomic features [1,2]. The TACs include cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA), and hemicrania continua .
Despite their common elements, the TACs differ in attack duration and frequency, as well as the response to therapy (table 1).
●Cluster headache has the longest attack duration (minutes to hours) and relatively low attack frequency (up to eight a day)
●Paroxysmal hemicrania has intermediate duration (minutes) and intermediate attack frequency (up to 40 a day)
●SUNCT/SUNA has the shortest attack duration (seconds to minutes) and the highest attack frequency (up to 200 a day)
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