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Update on the diagnosis and management of Trigemino-Autonomic Headaches

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Abstract

Severe shortlasting headaches are rare but very disabling conditions with a major impact on the patients’ quality of life. Following the IHS criteria, these headaches broadly divide themselves into those associated with autonomic symptoms, so called trigeminal autonomic cephalgias (TACs), and those with few autonomic symptoms. The trigeminal-autonomic cephalgias include cluster headache, paroxysmal hemicranias, and a syndrome called SUNCT (short lasting unilateral neuralgic cephalgias with conjunctival injection and tearing). In all of these syndromes, hemispheric head pain and cranial autonomic symptoms are prominent. The paroxysmal hemicranias have, unlike cluster headaches, a very robust response to indomethacin, leading to a notion of indomethacin-sensitive headaches. Although TACs are, in comparison with migraine, quite rare, it is nevertheless very important to consider the clinical factor that they are easy to diagnose and the treatment is very effective in most patients.

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Acknowledgments

The author wish to thank E. Schoell for editing the manuscript. AM is supported by a grant of the Deutsche Forschungsgemeinschaft (MA 1862/2) and by a grant of the BMBF (project no. 371 57 01).

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  1. Dept. of Systems Neuroscience, Universitäts-Krankenhaus Eppendorf (UKE), Martinistr. 52, D-20246, Hamburg, Germany

    Arne May MD

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Correspondence to Arne May MD.

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Received in revised form: 11 May 2006

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May, A. Update on the diagnosis and management of Trigemino-Autonomic Headaches. J Neurol 253, 1525–1532 (2006). https://doi.org/10.1007/s00415-006-0303-2

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