Abstract
The trigeminal autonomic cephalalgias (TACs) are a group of primary headache syndromes characterised by intense pain and associated activation of cranial parasympathetic autonomic outflow pathways out of proportion to the pain. The TACs include cluster headache, paroxysmal hemicrania and SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing). The pathophysiology of these syndromes involves activation of the trigeminal-autonomic reflex, whose afferent limb projects into the trigeminocervical complex in the caudal brainstem and upper cervical spinal cord. Functional brain imaging has shown activations in the posterior hypothalamic grey matter in TACs. This paper reviews the anatomy and physiology of these conditions and the brain imaging findings. Current treatments are summarised and the role of neuromodulation procedures, such as occipital nerve stimulation and deep brain stimulation in the posterior hypothalamus are reviewed. Neuromodulatory procedures are a promising avenue for these highly disabled patients with treatment refractory TACs.
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References
Afridi S, Giffin NJ, Kaube H, Friston KJ, Ward NS, Frackowiak RS, Goadsby PJ (2005) A PET study in spontaneous migraine. Arch Neurol 62: 1270–1275
Ambrosini A, Vandenheede M, Rossi P, Aloj F, Sauli E, Pierelli F, Schoenen J (2005) Suboccipital injection with a mixture of rapid and long-acting steroids in cluster headache: a double-blind placebo-controlled study. Pain 118: 92–96
Andersson PG, Jespersen LT (1986) Dihydroergotamine nasal spray in the treatment of attacks of cluster headache. Cephalalgia 6: 51–54
Anthony M (1985) Arrest of attacks of cluster headache by local steroid injection of the occipital nerve. In: Rose FC (ed) Migraine: clinical and research advances. Karger, London, pp 169–173
Bahra A, Matharu MS, Buchel C, Frackowiak RSJ, Goadsby PJ (2001) Brainstem activation specific to migraine headache. Lancet 357: 1016–1017
Bahra A, May A, Goadsby PJ (2002) Cluster headache: a prospective clinical study in 230 patients with diagnostic implications. Neurology 58: 354–361
Barbanti P, Fabbrini G, Pesare M, Vanacore N, Cerbo R (2002) Unilateral cranial autonomic symptoms in migraine. Cephalalgia 22: 256–259
Bartsch T, Levy MJ, Knight YE, Goadsby PJ (2004) Differential modulation of nociceptive dural input to [hypocretin] Orexin A and B receptor activation in the posterior hypothalamic area. Pain 109: 367–378
Benjamin L, Levy MJ, Lasalandra MP, Knight YE, Akerman S, Classey JD, Goadsby PJ (2004) Hypothalamic activation after stimulation of the superior sagittal sinus in the cat: a Fos study. Neurobiol Dis 16: 500–505
Benoliel R, Sharav Y (1998) Trigeminal neuralgia with lacrimation or SUNCT syndrome? Cephalalgia 18: 85–90
Black DF, Dodick DW (2002) Two cases of medically and surgically intractable SUNCT: a reason for caution and an argument for a central mechanism. Cephalalgia 22: 201–204
Boes CJ, Swanson JW, Dodick DW (1998) Chronic paroxysmal hemicrania presenting as otalgia with a sensation of external acoustic meatus obstruction: two cases and a pathophysiologic hypothesis. Headache 38: 787–791
Chakravarty A, Mukherjee A (2003) SUNCT syndrome responsive to lamotrigine: documentation of the first Indian case. Cephalalgia 23: 474–475
Cid C, Berciano J, Pascual J (2000) Retro-ocular headache with autonomic features resembling “continuous” cluster headache in a lateral medullary infarction. J Neurol Neurosurg Psychiatry 69: 134–141
Cittadini E, May A, Straube A, Evers S, Bussone G, Goadsby PJ (2006) Effectiveness of intranasal zolmitriptan in acute cluster headache. A randomized, placebo-controlled, double-blind crossover study. Arch Neurol 63: 1537–1542
Cohen AS, Goadsby PJ (2004) Functional neuroimaging of primary headache disorders. Curr Neurol Neurosci Rep 4: 105–110
Cohen AS, Matharu MS, Kalisch R, Friston K, Goadsby PJ (2004) Functional MRI in SUNCT shows differential hypothalamic activation with increasing pain. Cephalalgia 24: 1098–1099
Cooke LJ, Rose MS, Becker WJ (2000) Chinook winds and migraine headache. Neurology 54: 302–307
Cremer P, Halmagyi GM, Goadsby PJ (1995) Secondary cluster headache responsive to sumatriptan. J Neurol Neurosurg Psychiatry 59: 633–634
Curran DA, Hinterberger H, Lance JW (1967) Methysergide. Res Clin Studies Headache 1: 74–122
D’Andrea G, Granella F, Ghiotto N, Nappi G (2001) Lamotrigine in the treatment of SUNCT syndrome. Neurology 57: 1723–1725
de la Sayette V, Schaeffer S, Coskun O, Leproux F, Defer G (1999) Cluster headache-like attack as an opening symptom of a unilateral infarction of the cervical cord: persistent anaesthesia and dysaesthesia to cold stimuli. J Neurol Neurosurg Psychiatry 66: 397–400
Dodick DW, Trentman T, Zimmerman R, Eross EJ (2003) Occipital nerve stimulation for intractable chronic primary headache disorders. Cephalalgia 23: 701
Donnet A, Valade D, Regis J (2005) Gamma knife treatment for refractory cluster headache: prospective open trial. J Neurol Neurosurg Psychiatry 76: 218–221
Drummond PD (1988) Autonomic disturbance in cluster headache. Brain 111: 1199–1209
Drummond PD, Lance JW (1992) Pathological sweating and flushing accompanying the trigeminal lacrimation reflex in patients with cluster headache and in patients with a confirmed site of cervical sympathetic deficit. Evidence for parasympathetic cross-innervation. Brain 115: 1429–1445
Ekbom K, Greitz T (1970) Carotid angiography in cluster headache. Acta Radiol 10: 177–186
Ekbom K, Solomon S (2000) Management of cluster headache. In: Olesen J, Tfelt-Hansen P, Welch KMA (eds) The headaches, 2nd edn. Lippincott, Williams & Wilkins, Philadelphia, pp 731–740
Ekbom K, The Sumatriptan Cluster Headache Study Group (1991) Treatment of acute cluster headache with sumatriptan. N Engl J Med 325: 322–326
Ertsey C, Bozsik G, Afra J, Jelencsik I (2000) A case of SUNCT syndrome with neurovascular compression. Cephalalgia 20: 325
Feindel W, Penfield W, McNaughton F (1960) The tentorial nerves and localization of intracranial pain in man. Neurology 10: 555–563
Fogan L (1985) Treatment of cluster headache: a double blind comparison of oxygen vs air inhalation. Arch Neurol 42: 362–363
Forderreuther S, Mayer M, Straube A (2002) Treatment of cluster headache with topiramate: effects and side-effects in five patients. Cepahalalgia 22: 186–189
Franzini A, Ferroli P, Leone M, Broggi G (2003) Stimulation of the posterior hypothalamus for treatment of chronic intractable cluster headaches. The first reported series. Neurosurgery 52: 1095–1101
Frese A, Evers S, May A (2003) Autonomic activation in experimental trigeminal pain. Cephalalgia 23: 67–68
Giffin N, Goadsby PJ (2001) Basilar artery aneurysm with autonomic features: an interesting pathophysiological problem. J Neurol Neurosurg Psychiatry 71: 805–808
Gil-Gouveia R, Goadsby PJ (2005) Neuropsychiatric side effects of lidocaine: examples from the treatment of headache and a review. Cephalalgia 25 (in press)
Goadsby PJ (1989) Effect of stimulation of the facial nerve on regional cerebral blood flow and glucose utilization in cats. Am J Physiol 257: R517–R521
Goadsby PJ (1991) Characteristics of facial nerve elicited cerebral vasodilatation determined with laser Doppler flowmetry. Am J Physiol 260: R255–R262
Goadsby PJ (2002) Pathophysiology of cluster headache: a trigeminal autonomic cephalgia. Lancet Neurol 1: 37–43
Goadsby PJ (2002) Raeders Syndrome: “Paratrigeminal” paralysis of oculo-pupillary sympathetic. J Neurol Neurosurg Psychiatry 72: 297–299
Goadsby PJ, Edvinsson L (1994) Human in vivo evidence for trigeminovascular activation in cluster headache. Brain 117: 427–434
Goadsby PJ, Hoskin KL (1997) The distribution of trigeminovascular afferents in the nonhuman primate brain Macaca nemestrina: a c-fos immunocytochemical study. J Anat 190: 367–375
Goadsby PJ, Macdonald GJ (1985) Extracranial vasodilatation mediated by VIP (Vasoactive Intestinal Polypeptide). Brain Res 329: 285–288
Goadsby PJ, Lipton RB (1997) A review of paroxysmal hemicranias, SUNCT syndrome and other short-lasting headaches with autonomic features, including new cases. Brain 120: 193–209
Goadsby PJ, Shelley S (1990) High frequency stimulation of the facial nerve results in local cortical release of vasoactive intestinal polypeptide in the anesthetised cat. Neurosci Lett 112: 282–289
Goadsby PJ, Lambert GA, Lance JW (1983) Effects of locus coeruleus stimulation on carotid vascular resistance in the cat. Brain Res 278: 175–183
Goadsby PJ, Lambert GA, Lance JW (1984) The peripheral pathway for extracranial vasodilatation in the cat. J Auton Nerv Syst 10: 145–155
Goadsby PJ, Edvinsson L, Ekman R (1988) Release of vasoactive peptides in the extracerebral circulation of man and the cat during activation of the trigeminovascular system. Ann Neurol 23: 193–196
Goadsby PJ, Edvinsson L, Ekman R (1990) Vasoactive peptide release in the extracerebral circulation of humans during migraine headache. Ann Neurol 28: 183–187
Goadsby PJ, Edvinsson L, Ekman R (1992) Cutaneous stimulation leading to facial flushing and release of calcitonin gene-related peptide. Cephalalgia 12: 53–56
Goadsby PJ, Uddman R, Edvinsson L (1996) Cerebral vasodilatation in the cat involves nitric oxide from parasympathetic nerves. Brain Res 707: 110–118
Goadsby PJ, Matharu MS, Boes CJ (2001) SUNCT syndrome or trigeminal neuralgia with lacrimation. Cephalalgia 21: 82–83
Graff-Radford SB (2000) SUNCT syndrome responsive to gabapentin. Cephalalgia 20: 515–517
Greve E, Mai J (1988) Cluster headache-like headaches: a symptomatic feature? A report of three patients with intracranial pathologic findings. Cephalalgia 8: 79–82
Gutierrez-Garcia JM (2002) SUNCT syndrome responsive to lamotrigine. Headache 42: 823–825
Hannerz J (1989) A case of parasellar meningioma mimicking cluster headache. Cephalalgia 9: 265–269
Headache Classification Committee of The International Headache Society (1988) Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 8Suppl 7: 1–96
Headache Classification Committee of The International Headache Society (2004) The international classification of headache disorders, 2nd edn. Cephalalgia 24Suppl 1: 1–160
Heidegger S, Mattfeldt T, Rieber A, Wikstroem M, Kern P, Kern W, Schreiber H (1997) Orbito-sphenoidal aspergillus infection mimicking cluster headache: a case report. Cephalalgia 17: 676–679
Hunt CH, Dodick DW, Bosch P (2002) SUNCT responsive to gabapentin. Headache 42: 525–526
Hunter CR, Mayfield FH (1949) Role of the upper cervical roots in the production of pain in the head. Am J Surg 78: 743–749
Igarashi H, Sakai F (1996) Natural history of cluster headache. Cephalalgia 390–391
Irimia P, Cittadini E, Paemeliere K, Cohen A, Kaube H, Goadsby PJ (2006) Unilateral phonophobia and photophobia: a helpful symptom for the diagnosis of trigeminal autonomic cephalalgias (TACs) and hemicrania continua (HC). Cephalalgia (in press)
Jammes JL (1975) The treatment of cluster headaches with prednisone. Dis Nerv Syst 36: 375–376
Jarrar RG, Black DF, Dodick DW, Davis DH (2003) Outcome of trigeminal nerve section in the treatment of chronic cluster headache. Neurology 60: 1360–1362
Kirkpatrick PJ, O’Brien M, MacCabe JJ (1993) Trigeminal nerve section for chronic migrainous neuralgia. Br J Neurosurg 7: 483–490
Kitrelle JP, Grouse DS, Seybold ME (1985) Cluster headache: local anesthetic abortive agents. Arch Neurol 42: 496–498
Koenigsberg AD, Solomon GD, Kosmorsky DO (1994) Pseudoaneurysm within the cavernous sinus presenting as cluster headache. Headache 34: 111–113
Krabbe A, Steiner TJ (2000) Prophylactic treatment of cluster headache. In: Sjaastad O, Nappi G (eds) Cluster headache syndrome in general practice: basic concepts. Smith-Gordon, London, pp 91–96
Kudrow L (1980) Cluster headache: mechanisms and management. Oxford University Press, Oxford
Kuritzky A (1984) Cluster headache-like pain caused by an upper cervical meningioma. Cephalalgia 4: 185–186
Lainez MJ, Pascual J, Pascual AM, Santonja JM, Ponz A, Salvador A (2003) Topiramate in the prophylactic treatment of cluster headache. Headache 43: 784–749
Lambert GA, Bogduk N, Goadsby PJ, Duckworth JW, Lance JW (1984) Decreased carotid arterial resistance in cats in response to trigeminal stimulation. J Neurosurg 61: 307–315
Lance JW (1993) Mechanism and management of headache, 5th edn. Butterworth Scientific, London
Lance JW, Goadsby PJ (2005) Mechanism and management of headache, 7th edn. Elsevier, New York
Lee MS, Lessell S (2002) Orbital myositis posing as cluster headache. Arch Neurol 59: 635–636
Leira EC, Cruz-Flores S, Leacock RO, Abdulrauf SI (2001) Sumatriptan can alleviate headaches due to carotid artery dissection. Headache 41: 590–591
Leone M, D’Amico D, Moschiano F, Fraschini F, Bussone G (1996) Melatonin versus placebo in the prophylaxis of cluster headache: a double-blind pilot study with parallel groups. Cephalalgia 16: 494–496
Leone M, Rigamonti A, Usai S, D’Amico D, Grazzi L, Bussone G (2000) Two new SUNCT cases responsive to lamotrigine. Cephalalgia 20: 845–847
Leone M, Franzini A, Bussone G (2001) Stereotatic stimulation of the posterior hypothalamic gray matter in a patient with intractable cluster headache. New Engl J Med 345: 1428–1429
Leone M, Dodick D, Rigamonti A, D’Amico D, Grazzi L, Mea E, Bussone G (2003) Topiramate in cluster headache prophylaxis: an open trial. Cephalalgia 23: 1001–1002
Leone M, Franzini A, Broggi G, Dodick D, Rapoport A, Goadsby PJ, Schoenen J, Bonavita V, Bussone G (2004) Deep brain stimulation for intractable chronic cluster headache: proposals for patient selection. Cephalalgia 24: 934–937
Leone M, Franzini A, D’Andrea G, Broggi G, Casucci G, Bussone G (2005) Deep brain stimulation to relieve drug-resistant SUNCT. Ann Neurol 57: 924–927
Lovely TJ, Kotsiakis X, Jannetta PJ (1998) The surgical management of chronic cluster headache. Headache 38: 590–594
Mainardi F, Maggioni F, Dainese F, Amista P, Zanchin G (2002) Spontaneous carotid artery dissection with cluster-like headache. Cephalalgia 22: 557–559
Malick A, Burstein R (1998) Cells of origin of the trigeminohy-pothalamic tract in the rat. J Comparative Neurol 400: 125–144
Mani S, Deeter J (1982) Arteriovenous malformation of the brain presenting as a cluster headache — a case report. Headache 22: 184–185
Manzoni GC, Micieli G, Granella F, Tassorelli C, Zanferrari C, Cavallini A (1991) Cluster headache-course over ten years in 189 patients. Cephalalgia 11: 169–174
Matharu MS, Goadsby PJ (2002) Persistence of attacks of cluster headache after trigeminal nerve root section. Brain 175: 976–984
Matharu MS, Boes CJ, Goadsby PJ (2002) SUNCT syndrome: prolonged attacks, refractoriness and response to topiramate. Neurology 58: 1307
Matharu MS, Boes CJ, Goadsby PJ (2003) Management of trigeminal autonomic cephalalgias and hemicrania continua. Drugs 63: 1637–1677
Matharu MS, Cohen AS, Boes CJ, Goadsby PJ (2003) SUNCT syndrome: a review. Curr Pain Headache Rep 7: 308–318
Matharu MS, Bartsch T, Ward N, Frackowiak RSJ, Weiner RL, Goadsby PJ (2004) Central neuromodulation in chronic migraine patients with suboccipital stimulators: a PET study. Brain 127: 220–230
Matharu MS, Cohen AS, Goadsby PJ (2004) SUNCT syndrome responsive to intravenous lidocaine. Cephalalgia 24: 985–992
Matharu MS, Cohen AS, McGonigle DJ, Ward N, Frackowiak RSJ, Goadsby PJ (2004) Posterior hypothalamic and brainstem activation in hemicrania continua. Headache 44: 747–761
Matharu MS, Levy MJ, Meeran K, Goadsby PJ (2004) Subcutaneous octreotide in cluster headache-randomized placebo-controlled double-blind cross-over study. Ann Neurol 56: 488–494
Matharu MS, Cohen AS, Frackowiak RSJ, Goadsby PJ (2006) Posterior hypothalamic activation in paroxysmal hemicrania using PET. Cephalalgia 59: 535–545
Mathew NT, Hurt W (1998) Percutaneous radiofrequency trigeminal gangliorhizolysis in intractable cluster headache. Headache 28: 328–331
Mathew NT, Kailasam J, Meadors L (2002) Prophylaxis of migraine, transformed migraine, and cluster headache with topiramate. Headache 42: 796–803
May A, Goadsby PJ (1999) The trigeminovascular system in humans: pathophysiological implications for primary headache syndromes of the neural influences on the cerebral circulation. J Cereb Blood Flow Metabo 19: 115–127
May A, Bahra A, Buchel C, Frackowiak RSJ, Goadsby PJ (1998) Hypothalamic activation in cluster headache attacks. Lancet 352: 275–278
May A, Kaube H, Buchel C, Eichten C, Rijntjes M, Juptner M, Weiller C, Diener HC (1998) Experimental cranial pain elicited by capsaicin: a PET-study. Pain 74: 61–66
May A, Buchel C, Bahra A, Goadsby PJ, Frackowiak RSJ (1999) Intra-cranial vessels in trigeminal transmitted pain: a PET Study. NeuroImage 9: 453–460
May A, Bahra A, Buchel C, Turner R, Goadsby PJ (1999) Functional MRI in spontaneous attacks of SUNCT: short-lasting neuralgiform headache with conjunctival injection and tearing. Ann Neurol 46: 791–793
May A, Bahra A, Buchel C, Frackowiak RSJ, Goadsby PJ (2000) PET and MRA findings in cluster headache and MRA in experimental pain. Neurology 55: 1328–1335
May A, Buchel C, Turner R, Goadsby PJ (2001) MR-angiography in facial and other pain: neurovascular mechanisms of trigeminal sensation. J Cereb Blood Flow Metabol 21: 1171–1176
McNaughton FL, Feindel WH (1977) Innervation of intracranial structures: a reappraisal. In: Rose FC (ed) Physiological aspects of clinical neurology. Blackwell Scientific Publications, Oxford, pp 279–293
Munoz C, Diez-Tejedor E, Frank A, Barreiro P (1996) Cluster headache syndrome associated with middle cerebral artery arteriovenous malformation. Cephalalgia 16: 202–205
Nakai M, Tamaki K, Ogata J, Maeda M (1993) Parasympathetic cerebrovascular center of the facial nerve. Circ Res 72: 470–475
Pareja JA, Sjaastad O (1997) SUNCT syndrome. A clinical review. Headache 37: 195–202
Pareja JA, Kruszewski P, Sjaastad O (1995) SUNCT syndrome: trials of drugs and anesthetic blockades. Headache 35: 138–142
Pareja JA, Joubert J, Sjaastad O (1996) SUNCT syndrome. Atypical temporal patterns. Headache 36: 108–110
Pareja JA, Ming JM, Kruszewski P, Caballero V, Pamo M, Sjaastad O (1996) SUNCT syndrome: duration, frequency and temporal distribution of attacks. Headache 36: 161–165
Pareja JA, Ruiz J, Deisla C, Alsabbah H, Espejo J (1996) Idiopathic stabbing headache (jabs and jolts syndrome). Cephalalgia 16: 93–96
Pareja JA, Kruszewski P, Caminero AB (1999) SUNCT syndrome versus idiopathic stabbing headache (jabs and jolts syndrome). Cephalalgia 19Suppl 25: 46–48
Peatfield R, Bahra A, Goadsby PJ (1998) Trigeminal-autonomic cephalgias (TACs). Cephalalgia 18: 358–361
Peres MFP, Stiles MA, Siow HC, Rozen TD, Young WB, Silberstein SD (2002) Greater occipital nerve blockade for cluster headache. Cephalalgia 22: 520–522
Piovesan EJ, Siow C, Kowacs PA, Werneck LC (2003) Influence of lamotrigine over the SUNCT syndrome: one patient follow-up for two years. Arq Neuropsiquiatr 61: 691–694
Porta-Etessam J, Martinez-Salio A, Berbel A, Benito-Leon J (2002) Gabapentin (neurontin) in the treatment of SUNCT syndrome. Cephalalgia 22: 249
Porta-Etessam J, Ramos-Carrasco A, Berbel-Garcia A, Martinez-Salio A, Benito-Leon J (2001) Clusterlike headache as first manifestation of a prolactinoma. Headache 41: 723–725
Raimondi E, Gardella L (1998) SUNCT syndrome. Two cases in Argentina. Headache 38: 369–371
Rapoport AM, Bigal ME, Tepper SJ, Sheftell FD (2003) Treatment of cluster headache with topiramate: effects and side-effects in five patients. Cephalalgia 23: 69–70
Schoenen J, Di Clemente L, Vandenheede M, Fumal A, De Pasqua V, Mouchamps M, Remacle JM, de Noordhout AM (2005) Hypothalamic stimulation in chronic cluster headache: a pilot study of efficacy and mode of action. Brain 128: 940–947
Scorticati MC, Raina G, Federico M (2002) Cluster-like headache associated to a foreign body in the maxillary sinus. Neurology 59: 643–644
Seylaz J, Hara H, Pinard E, Mraovitch S, MacKenzie ET, Edvinsson L (1988) Effect of stimulation of the sphenopalatine ganglion on cortical blood flow in the rat. J Cereb Blood Flow Metabol 8: 875–878
Shields KG, Levy MJ, Goadsby PJ (2004) Alopecia and cutaneous atrophy following greater occipital nerve infiltration. Neurology 63: 2193–2194
Silberstein SD, Niknam R, Rozen TD, Young WB (2000) Cluster headache with aura. Neurology 54: 219–221
Siow HC, Young WB, Peres MF, Rozen TD, Silberstein SD (2002) Hemiplegic cluster. Headache 42: 136–139
Sjaastad O (1992) Cluster Headache Syndrome. Saunders WB, London
Sjaastad O, Russell D, Horven I, Bunnaes U (1978) Multiple neuralgiform unilateral headache attacks associated with conjunctival injection and appearing in clusters. A nosological problem. Proceedings of the Scandinavian Migraine Society, Arhus, 31
Sjaastad O, Saunte C, Salvesen R, Fredriksen TA, Seim A, Roe OD, Fostad K, Lobben OP, Zhao JM (1989) Shortlasting unilateral neuralgiform headache attacks with conjunctival injection, tearing, sweating, and rhinorrhea. Cephalalgia 9: 147–156
Sjaastad O, Kruszewski P (1992) Trigeminal neuralgia and “SUNCT” syndrome: similarities and differences in the clinical picture. An overview. Functional Neurology 7: 103–107
Spencer SE, Sawyer WB, Wada H, Platt KB, Loewy AD (1990) CNS projections to the pterygopalatine parasympathetic preganglionic neurons in the rat: a retrograde transneuronal viral cell body labeling study. Brain Res 534: 149–169
Sprenger T, Boecker H, Tolle TR, Bussone G, May A, Leone M (2004) Specific hypothalamic activation during a spontaneous cluster headache attack. Neurology 62: 516–517
Tfelt-Hansen P, Paulson OB, Krabbe AE (1982) Invasive adenoma of the pituitary gland and chronic migrainous neuralgia. A rare coincidence or a causal relationship? Cephalalgia 2: 25–28
Uddman R, Tajti J, Moller S, Sundler F, Edvinsson L (1999) Neuronal messengers and peptide receptors in the human sphenopalatine and otic ganglia. Brain Res 826: 193–199
Weiller C, May A, Limmroth V, Juptner M, Kaube H, Schayck RV, Coenen HH, Diener HC (1995) Brainstem activation in spontaneous human migraine attacks. Nat Med 1: 658–660
Weiner RL, Reed KL (1999) Peripheral neurostimulation for control of intractable occipital neuralgia. Neuromodulation 2: 217–222
West P, Todman D (1991) Chronic cluster headache associated with a vertebral artery aneurysm. Headache 31: 210–212
Wheeler SD, Carrazana EJ (1999) Topiramate-treated cluster headache. Neurology 53: 234–236
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Goadsby, P.J. (2007). Neuromodulatory approaches to the treatment of trigeminal autonomic cephalalgias. In: Sakas, D.E., Simpson, B.A. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/2. Springer, Vienna. https://doi.org/10.1007/978-3-211-33081-4_12
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