ABSTRACT
The trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders that include cluster headache (CH), paroxysmal hemicrania (PH), and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing/cranial autonomic features (SUNCT/SUNA). Hemicrania continua (HC) is often included with this group, although the second edition of The International Classification of Headache Disorders did not link the entities. Trigeminal autonomic cephalalgias are generally characterized by relatively short-lasting attacks of severe pain and lateralized associated features including the pain, cranial autonomic symptoms, and where present, migrainous symptoms, such as photophobia. Paroxysmal hemicrania has intermediate duration and intermediate attack frequency. Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing has the shortest attack duration and the highest attack frequency. Hemicrania continua has a continuous pain with exacerbations that can include cranial autonomic symptoms as part of the phenotype. The syndromes share much in their pathophysiology and investigation paths; however, their treatment is distinct, so that the accurate differentiation is important for optimal management.
KEYWORDS
Paroxysmal hemicrania - SUNCT - SUNA - hemicrania continua
REFERENCES
-
1
Goadsby P J, Lipton R B.
A review of paroxysmal hemicranias, SUNCT syndrome and other short-lasting headaches with autonomic feature, including new cases.
Brain.
1997;
120(Pt 1)
193-209
-
2
Goadsby P J, Cohen A S, Matharu M S.
Trigeminal autonomic cephalalgias: diagnosis and treatment.
Curr Neurol Neurosci Rep.
2007;
7(2)
117-125
-
3
Headache Classification Subcommittee of the International Headache Society .
The international classification of headache disorders, 2nd edition.
Cephalalgia.
2004;
24(Suppl 1)
1-160
-
4
Goadsby P J, Cittadini E, Burns B, Cohen A S.
Trigeminal autonomic cephalalgias: diagnostic and therapeutic developments.
Curr Opin Neurol.
2008;
21(3)
323-330
-
5
Antonaci F, Sjaastad O.
Chronic paroxysmal hemicrania (CPH): a review of the clinical manifestations.
Headache.
1989;
29(10)
648-656
-
6
Cittadini E, Matharu M S, Goadsby P J.
Paroxysmal hemicrania: a prospective clinical study of 31 cases.
Brain.
2008;
131(Pt 4)
1142-1155
-
7
Boes C J, Dodick D W.
Refining the clinical spectrum of chronic paroxysmal hemicrania: a review of 74 patients.
Headache.
2002;
42(8)
699-708
-
8
Irimia P, Cittadini E, Paemeleire K, Cohen A S, Goadsby P J.
Unilateral photophobia or phonophobia in migraine compared with trigeminal autonomic cephalalgias.
Cephalalgia.
2008;
28(6)
626-630
-
9
Sjaastad O.
Chronic paroxysmal hemicrania, hemicrania continua and SUNCT: the fate of the three first described cases.
J Headache Pain.
2006;
7(3)
151-156
-
10
Mathew N T, Kailasam J, Fischer A.
Responsiveness to celecoxib in chronic paroxysmal hemicrania.
Neurology.
2000;
55(2)
316
-
11
Lisotto C, Maggioni F, Mainardi F, Zanchin G.
Rofecoxib for the treatment of chronic paroxysmal hemicrania.
Cephalalgia.
2003;
23(4)
318-320
-
12
Siow H C.
Seasonal episodic paroxysmal hemicrania responding to cyclooxygenase-2 inhibitors.
Cephalalgia.
2004;
24(5)
414-415
-
13
Moore R A, Derry S, Makinson G T, McQuay H J.
Tolerability and adverse events in clinical trials of celecoxib in osteoarthritis and rheumatoid arthritis: systematic review and meta-analysis of information from company clinical trial reports.
Arthritis Res Ther.
2005;
7(3)
R644-R665
-
14
Camarda C, Camarda R, Monastero R.
Chronic paroxysmal hemicrania and hemicrania continua responding to topiramate: two case reports.
Clin Neurol Neurosurg.
2008;
110(1)
88-91
-
15
Cohen A S, Goadsby P J.
Paroxysmal hemicrania responding to topiramate.
J Neurol Neurosurg Psychiatry.
2007;
78(1)
96-97
-
16
Pascual J, Quijano J.
A case of chronic paroxysmal hemicrania responding to subcutaneous sumatriptan.
J Neurol Neurosurg Psychiatry.
1998;
65(3)
407
-
17
Antonaci F, Pareja J A, Caminero A B, Sjaastad O.
Chronic paroxysmal hemicrania and hemicrania continua: lack of efficacy of sumatriptan.
Headache.
1998;
38(3)
197-200
-
18
Dahlöf C.
Subcutaneous sumatriptan does not abort attacks of chronic paroxysmal hemicrania (CPH).
Headache.
1993;
33(4)
201-202
-
19
Afridi S K, Shields K G, Bhola R, Goadsby P J.
Greater occipital nerve injection in primary headache syndromes—prolonged effects from a single injection.
Pain.
2006;
122(1-2)
126-129
-
20
Cohen A S, Matharu M S, Goadsby P J.
Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) or cranial autonomic features (SUNA)—a prospective clinical study of SUNCT and SUNA.
Brain.
2006;
129(Pt 10)
2746-2760
-
21
Goadsby P J, Matharu M S, Boes C J.
SUNCT syndrome or trigeminal neuralgia with lacrimation.
Cephalalgia.
2001;
21(2)
82-83
-
22
Pareja J A, Kruszewski P, Sjaastad O.
SUNCT syndrome: trials of drugs and anesthetic blockades.
Headache.
1995;
35(3)
138-142
-
23
D'Andrea G, Granella F, Cadaldini M.
Possible usefulness of lamotrigine in the treatment of SUNCT syndrome.
Neurology.
1999;
53(7)
1609
-
24
Leone M, Rigamonti A, Usai S, Damico D, Grazzi L, Bussone G.
Two new SUNCT cases responsive to lamotrigine.
Cephalalgia.
2000;
20(9)
845-847
-
25
D'Andrea G, Granella F, Ghiotto N, Nappi G.
Lamotrigine in the treatment of SUNCT syndrome.
Neurology.
2001;
57(9)
1723-1725
-
26
Gutierrez-Garcia J M.
SUNCT syndrome responsive to lamotrigine.
Headache.
2002;
42(8)
823-825
-
27
Chakravarty A, Mukherjee A.
SUNCT syndrome responsive to lamotrigine: documentation of the first Indian case.
Cephalalgia.
2003;
23(6)
474-475
-
28
Piovesan E J, Siow C, Kowacs P A, Werneck L C.
Influence of lamotrigine over the SUNCT syndrome: one patient follow-up for two years.
Arq Neuropsiquiatr.
2003;
61(3A)
691-694
-
29
Malik K, Rizvi S, Vaillancourt P D.
The SUNCT syndrome: successfully treated with lamotrigine.
Pain Med.
2002;
3(2)
167-168
-
30
Cohen A S, Matharu M S, Goadsby P J.
Suggested guidelines for treating SUNCT and SUNA.
Cephalalgia.
2005;
25
1200
-
31
Matharu M S, Boes C J, Goadsby P J.
SUNCT syndrome: prolonged attacks, refractoriness and response to topiramate.
Neurology.
2002;
58(8)
1307
-
32
Rossi P, Cesarino F, Faroni J, Malpezzi M G, Sandrini G, Nappi G.
SUNCT syndrome successfully treated with topiramate: case reports.
Cephalalgia.
2003;
23(10)
998-1000
-
33
Hunt C H, Dodick D W, Bosch E P.
SUNCT responsive to gabapentin.
Headache.
2002;
42(6)
525-526
-
34
Porta-Etessam J, Benito-Leon J, Martinez-Salio A, Berbel A.
Gabapentin in the treatment of SUNCT syndrome.
Headache.
2002;
42(6)
523-524
-
35
Graff-Radford S B.
SUNCT syndrome responsive to gabapentin (Neurontin).
Cephalalgia.
2000;
20(5)
515-517
-
36
Cohen A S, Matharu M S, Goadsby P J.
Double-blind placebo-controlled trial of topiramate in SUNCT.
Cephalalgia.
2007;
27
758
-
37
Medina J L, Diamond S.
Cluster headache variant. Spectrum of a new headache syndrome.
Arch Neurol.
1981;
38(11)
705-709
-
38
Sjaastad O, Spierings E L.
“Hemicrania continua”: another headache absolutely responsive to indomethacin.
Cephalalgia.
1984;
4(1)
65-70
-
39
Peres M FP, Silberstein S D, Nahmias S et al..
Hemicrania continua is not that rare.
Neurology.
2001;
57(6)
948-951
-
40
Wheeler S D, Allen K F, Pusey T.
Is hemicrania continua a migraine variant?.
Cephalalgia.
2001;
21
508-509
-
41
Pasquier F, Leys D, Petit H.
“Hemicrania continua”: the first bilateral case?.
Cephalalgia.
1987;
7(3)
169-170
-
42
Iordanidis T, Sjaastad O.
Hemicrania continua: a case report.
Cephalalgia.
1989;
9(4)
301-303
-
43
Trucco M, Antonaci F, Sandrini G.
Hemicrania continua: a case responsive to piroxicam-beta-cyclodextrin.
Headache.
1992;
32(1)
39-40
-
44
Marano E, Giampiero V, Gennaro D R, di Stasio E, Bonusa S, Sorge F.
“Hemicrania continua”: a possible case with alternating sides.
Cephalalgia.
1994;
14(4)
307-308
-
45
Newman L C, Spears R C, Lay C L.
Hemicrania continua: a third case in which attacks alternate sides.
Headache.
2004;
44(8)
821-823
-
46
Matharu M S, Bradbury P, Swash M.
Hemicrania continua: side alternation and response to topiramate.
Cephalalgia.
2006;
26(3)
341-344
-
47
Baldacci F, Nuti A, Cafforio G et al..
‘INDOTEST’ in atypical hemicrania continua.
Cephalalgia.
2008;
28(3)
300-301
-
48
Newman L C, Lipton R B, Russell M, Solomon S.
Hemicrania continua: attacks may alternate sides.
Headache.
1992;
32(5)
237-238
-
49
Bordini C, Antonaci F, Stovner L J, Schrader H, Sjaastad O.
“Hemicrania continua”: a clinical review.
Headache.
1991;
31(1)
20-26
-
50
Newman L C, Lipton R B, Solomon S.
Hemicrania continua: ten new cases and a review of the literature.
Neurology.
1994;
44(11)
2111-2114
-
51
Peres M FP, Siow H C, Rozen T D.
Hemicrania continua with aura.
Cephalalgia.
2002;
22(3)
246-248
-
52
Peres M FP, Zukerman E.
Hemicrania continua responsive to rofecoxib.
Cephalalgia.
2000;
20(2)
130-131
-
53
Brighina F, Palermo A, Cosentino G, Fierro B.
Prophylaxis of hemicrania continua: two new cases effectively treated with topiramate.
Headache.
2007;
47(3)
441-443
-
54
Burns B, Watkins L, Goadsby P J.
Treatment of hemicrania continua by occipital nerve stimulation with a bion device: long-term follow-up of a crossover study.
Lancet Neurol.
2008;
7
1001-1012
-
55
Goadsby P J.
Lacrimation, conjunctival injection, nasal symptoms... cluster headache, migraine and cranial autonomic symptoms in primary headache disorders — what's new?.
J Neurol Neurosurg Psychiatry.
2009;
80(10)
1057-1058
-
56
Lai T H, Fuh J L, Wang S J.
Cranial autonomic symptoms in migraine: characteristics and comparison with cluster headache.
J Neurol Neurosurg Psychiatry.
2009;
80(10)
1116-1119
-
57
Levy M J, Matharu M S, Meeran K, Powell M, Goadsby P J.
The clinical characteristics of headache in patients with pituitary tumours.
Brain.
2005;
128(Pt 8)
1921-1930
-
58
Cohen A S, Goadsby P J.
Functional neuroimaging of primary headache disorders.
Expert Rev Neurother.
2006;
6(8)
1159-1171
-
59
Leone M, Patruno G, Vescovi A, Bussone G.
Neuroendocrine dysfunction in cluster headache.
Cephalalgia.
1990;
10(5)
235-239
-
60
Favier I, van Vliet J A, Roon K I et al..
Trigeminal autonomic cephalgias due to structural lesions: a review of 31 cases.
Arch Neurol.
2007;
64(1)
25-31
-
61
Matharu M S, Levy M J, Merry R T, Goadsby P J.
SUNCT syndrome secondary to prolactinoma.
J Neurol Neurosurg Psychiatry.
2003;
74(11)
1590-1592
-
62
Levy M J, Matharu M S, Goadsby P J.
Prolactinomas, dopamine agonists and headache: two case reports.
Eur J Neurol.
2003;
10(2)
169-173
-
63
Bahra A, May A, Goadsby P J.
Cluster headache: a prospective clinical study with diagnostic implications.
Neurology.
2002;
58(3)
354-361
Professor Peter J GoadsbyM.D.
Headache Group, Department of Neurology, UCSF Headache Center
1701 Divisadero Street, San Francisco, CA 94115
eMail: peter.goadsby@ucsf.edu
