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Case 28

  • Michael S. Lee
  • Kathleen B. Digre
Chapter

Summary Points

  1. 1.

    Trigeminal autonomic cephalgias are unilateral headaches with autonomic (red eye, tearing, nasal stuffiness, rhinorrhea) symptoms. The Horner syndrome can be permanent.

     
  2. 2.

    Cluster headache last 15 min to 3 h (no shorter and no longer).

     
  3. 3.

    All patients should be scanned before diagnosing cluster or other trigeminal autonomic cephalgias.

     
  4. 4.

    Acute treatment of cluster includes oxygen, triptans, and corticosteroids.

     
  5. 5.

    Prophylactic therapies include verapamil, topiramate, and lithium.

     
  6. 6.

    Prophylactic therapy for paroxysmal hemicranias and hemicranias continua is indomethacin.

     

Keywords

Cluster headache Trigeminal autonomic cephalgia Paroxysmal hemicranias Short Unilateral Neuralgiform headache with conjunctival injection and tearing (SUNCT) Hemicrania continua Horner’s syndrome Sympathetic dysfunction Unilateral photophobia 

For Further Study

  1. 1.
    Goadsby PJ. Trigeminal autonomic cephalalgias. Continuum (Minneap Minn). 2012;18(4):883–95.Google Scholar
  2. 2.
    May A. Diagnosis and clinical features of trigemino-autonomic headaches. Headache. 2013;53(9):1470–8.CrossRefPubMedGoogle Scholar
  3. 3.
    May A, Leone M, Afra J, Linde M, Sándor PS, Evers S, Goadsby PJ, EFNS Task Force. EFNS guidelines on the treatment of cluster headache and other trigeminal-autonomic cephalalgias. Eur J Neurol. 2006;13(10):1066–77.CrossRefPubMedGoogle Scholar
  4. 4.
    Nesbitt AD, Goadsby PJ. Cluster headache. BMJ. 2012;344:e2407.CrossRefPubMedGoogle Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Michael S. Lee
    • 1
  • Kathleen B. Digre
    • 2
  1. 1.University of MinnesotaMinneapolisUSA
  2. 2.University of UtahSalt Lake CityUSA

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