title: Trigeminal autonomic cephalalgias.
abstract: OBJECTIVE
  This article covers the clinical manifestations and differential diagnosis of the trigeminal autonomic cephalalgias (TACs).
  
  
  RESULTS
  TACs comprise a subgroup of primary headache disorders presenting with lateralized, often severe, pain accompanied by cranial autonomic features. The key syndromes are cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)/short-lasting unilateral neuralgiform headache attacks with cranial autonomic features (SUNA), and hemicrania continua. Lateralization of symptoms and signs is the key feature differentiating the TACs and migraine. When diagnosing a TAC, it is appropriate to consider underlying pituitary or pituitary region pathology. Cluster headache responds to oxygen and parenteral triptans, with verapamil having the most success for prevention. Paroxysmal hemicrania responds to indomethacin. SUNCT/SUNA responds to lamotrigine and topiramate. Hemicrania continua responds to indomethacin.
  
  
  CONCLUSIONS
  TACs are a unique group of primary headache syndromes with individual features and specific responses to treatment that make their identification crucial for optimum management.
authors.affiliation: Department of Neurology, UCSF Headache Center, San Francisco, CA, USA. pgoadsby@headache.ucsf.edu
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Goadsby
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology*; D003937:Diagnosis, Differential; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D051303:Trigeminal Autonomic Cephalalgias / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy