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Year : 2015  |  Volume : 3  |  Issue : 1  |  Page : 8-14

Trigeminal autonomic cephalalgias

Professor, Department of Neurology, SBKS MI & RC, Piparia, Waghodia, Vadodara, Gujarat, India

Correspondence Address:
Sanjay Prakash
Professor, Department of Neurology, SBKS MI & RC, Piparia, Waghodia, Vadodara, Gujarat
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2347-6486.238521

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TACs are a group of primary headaches with pain and autonomic features in the distribution of trigeminal nerve on one side. They are also associated with marked restlessness/agitation. The TACs include the following 5 entities: cluster headache (CH), paroxysmal hemicranias (PH), short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), Short lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA), and hemicranias continua (HC). All TACs are episodic headache disorders except HC. The TACs differ in attack duration and frequency. CH has the longest attack duration (15-180 minutes) and relatively low attack frequency. PH has intermediate duration (2-30 minutes) and intermediate attack frequency. SUNCT and SUNA have the shortest attack (1-600 seconds) duration and the highest attack frequency. Hemicrania continua are characterized by continuous strictly unilateral pain in trigeminal distribution with variable exacerbations. The most specific part of this group is that they all respond to highly ‘selective’ drug. The drugs commonly used for other headache disorders are largely ineffective here. CH responds to lithium and verapamil. SUNCT and SUNA show response to lamotrigine. HC and PH show dramatic response to indomethacin.

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