Strategies for the treatment of autonomic trigeminal cephalalgias.
Trigeminal autonomic cephalalgias (TACs) are a group of primary headache syndromes characterised by two main clinical characteristics: pain and oculofacial autonomic phenomena. Three headache forms are grouped as TACs: cluster headache (CH), paroxysmal hemicrania (PH) and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT). These are distinguished mainly on the basis of attack duration. It lasts from 15 to 180 min in CH, from 2 to 30 min in PH and from 5 to 240 s in SUNCT. The most effective drug preventative in PH is indomethacin even if in few cases other non-steroidal anti-inflammatory drugs have been reported to be effective. SUNCT is commonly described as drug resistant. Recent studies report that lamotrigin may be the drug of choice for SUNCT.
Leone
M
M
Headache Centre, National Neurological Institute C. Besta, Via Celoria 11, I-20133 Milan, Italy. leone@istituto-besta.it
Franzini
A
A
D'Amico
D
D
Grazzi
L
L
Mea
E
E
Curone
M
M
Tullo
V
V
Broggi
G
G
D'Andrea
G
G
Bussone
G
G
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000601:surgery / Q000628:therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003027:Cluster Headache / Q000209:etiology / Q000628:therapy; D006261:Headache / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008094:Lithium / Q000627:therapeutic use; D008784:Methysergide / Q000627:therapeutic use; D012702:Serotonin Antagonists / Q000627:therapeutic use; D014277:Trigeminal Neuralgia / Q000150:complications / Q000601:surgery / Q000628:therapy*; D014700:Verapamil / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D002121:Calcium Channel Blockers; D012702:Serotonin Antagonists; D008094:Lithium; D014700:Verapamil; D008784:Methysergide