Abstract
The trigeminal autonomic cephalalgias include cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks, and hemicrania continua. While the majority responds to conventional pharmacological treatments, a small but significant proportion of patients are intractable to these treatments. In these cases, alternative choices for these patients include oral and injectable drugs, lesional or resectional surgery, and neurostimulation. The evidence base for conventional treatments is limited, and the evidence for those used beyond convention is more so. At present, the most evidence exists for nerve blocks, deep brain stimulation, occipital nerve stimulation, sphenopalatine ganglion stimulation in chronic cluster headache, and microvascular decompression of the trigeminal nerve in short-lasting unilateral neuralgiform headache attacks.
Highlights
Trigeminal autonomic cephalalgias (TACs) are primary headache disorders characterized by unilateral head pain occurring
Gabapentin has been reported in one open-label study and three case reports to be efficacious in short-lasting unilateral neuralgiform headache attacks
cluster headache (CH), paroxysmal hemicrania (PH), hemicrania continua (HC), and short-lasting unilateral neuralgiform headache attacks are well-defined stereotyped syndromes that can be differentiated by their clinical features and treatment responses
Summary
Trigeminal autonomic cephalalgias (TACs) are primary headache disorders characterized by unilateral head pain occurring. The evidence is limited to case reports, but oral drugs that may prove useful include COX-2 inhibitors (Rofecoxib and Celecoxib) [51, 52], melatonin [53,54,55], topiramate [44, 56,57,58], verapamil [59, 60], and gabapentin [58, 61, 62] These conditions consist of attacks of moderate or severe, strictly unilateral head pain lasting seconds to minutes, which occur at least once a day and are usually associated with prominent lacrimation and redness of the ipsilateral eye [1]. Kuhn et al [70], Matharu et al [71], Rossi et al [72] 4 Positive 4/4 with follow-up of 5–9 months
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