Trigeminal autonomic cephalalgias

Background

• A group of headache syndromes characterized by severe, unilateral pain, typically in the distribution of the trigeminal nerve and accompanied by autonomic signs or symptoms
• Includes the following:
  • Cluster headache
  • Paroxysmal hemicrania
  • Hemicrania continua
  • Short-lasting, unilateral, neuralgiform headache attacks with cranial autonomic features (SUNA)
  • Short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)

Clinical Manifestations

• Severe unilateral headache with autonomic signs1

Management

• Treat acute with oxygen, nasal sumatriptan, steroids
• For chronic, try verapamil and lithium

Further Reading

• Trigeminal autonomic cephalgias. Br J Pain. 2012;6(3):106-123. doi: 10.1177/2049463712456355. PMID: 26516482; PMCID: PMC4590147.