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Cluster and other trigeminal autonomic cephalalgias 

Cluster and other trigeminal autonomic cephalalgias
Cluster and other trigeminal autonomic cephalalgias

Anna S Cohen

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date: 26 September 2020

Trigeminal autonomic cephalalgias (TACs) are characterized by attacks of severe unilateral pain and accompanying ipsilateral cranial autonomic features.

Attacks of paroxysmal hemicrania (PH) and SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) are more frequent and shorter than in cluster headache (CH).

In CH, the episodic form prevails; in other TACs, the chronic form is more common.

Characteristic triggers for attacks include alcohol for CH, and cutaneous triggers for SUNCT.

All TACs are generally primary syndromes, but underlying lesions such as pituitary tumours and posterior fossa lesions must be excluded.

Brain magnetic resonance imaging is the recommended investigation for all new diagnoses of TAC.

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