Trigeminal autonomic cephalalgias

Abstract

Trigeminal autonomic cephalalgias is the group of primary headaches that include cluster headache, paroxysmal hemicranias, hemicranias continua and short-lasting unilateral neuralgic-like headache attacks. The common manifestations of these headache types are spontaneous attack of unilateral severe pain of orbital, supraorbital and/or temporal localization which are accompanied with ipsilateral cranial autonomic symptoms including conjunctival injection, lacrimation, nasal blockage, rhinorrhea, eyelid edema, facial sweating, feeling of ear fullness, miosis or ptosis. Agitation and restlessness during attacks are typical for all trigeminal autonomic cephalalgias. Pathophysiology has centered on the activation of the posterior hypothalamus and trigeminal autonomic reflex. But these trigeminal autonomic cephalalgias are differentiated by the duration, daily frequency of attacks, diurnal rhythms and reaction to different treatment and preventive medication.