Short-lasting unilateral neuralgiform headache attacks: Clinical features and diagnosis
- Manjit S Matharu, MD
Manjit S Matharu, MD
- Consultant Neurologist
- The National Hospital for Neurology and Neurosurgery, London
- Anna S Cohen, MD
Anna S Cohen, MD
- Consultant Neurologist
- Royal Free Hospital, London
INTRODUCTION AND CLASSIFICATION
The trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders characterized by unilateral trigeminal distribution pain that occurs in association with ipsilateral cranial autonomic features [1,2]. The TACs include cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks, and hemicrania continua .
Despite their common elements, the TACs differ in attack duration and frequency, as well as the response to therapy (table 1).
●Hemicrania continua is characterized by continuous pain with exacerbations
●Cluster headache has a relatively long attack duration and relatively low attack frequency
●Paroxysmal hemicrania has intermediate duration and intermediate attack frequency
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- INTRODUCTION AND CLASSIFICATION
- HISTORICAL ASPECTS
- CLINICAL FEATURES
- Site of pain
- Duration, frequency and temporal profile of individual attacks
- Interictal pain
- Family history
- Lack of refractory period
- Neurologic examination
- Diagnostic criteria
- Distinguishing features
- Response to treatment
- DIFFERENTIAL DIAGNOSIS
- Trigeminal neuralgia
- Secondary headache
- - Posterior fossa lesions
- - Pituitary lesions
- - Trigeminal neurovascular loop
- SUMMARY AND RECOMMENDATIONS