How Cluster Headache and Other Trigeminal Autonomic Cephalalgias Present

  • Henrik Winther Schytz
  • Cristina Tassorelli
  • Messoud Ashina
Reference work entry


The trigeminal autonomic cephalalgias (TACs) comprise of cluster headache (CH), paroxysmal hemicrania (PH), and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT). The TACs consist of severe headache attacks accompanied by prominent oculocephalic autonomic features. The TACs occur in both episodic and chronic forms, in which the episodic form is most frequent in CH compared to the predominance of chronic PH and chronic SUNCT. The three TACs can be differentiated from each other according to their attack duration, attack frequency, and therapeutic treatment response. CH has the longest duration of attacks with the lowest daily frequency. PH has an intermediate attack duration and frequency, whereas SUNCT has the shortest attack duration and highest daily attack frequency. CH is much more prevalent than PH and SUNCT, and is also characterized with more frequent nocturnal attacks as well as annual periodicity. CH may be triggered by alcohol and nitroglycerin during a cluster period. In contrast to CH and PH, SUNCT is very often triggered by cutaneous stimuli. A successful response oxygen treatment points to the CH diagnosis, a successful indomethacin-test strongly indicate PH, whereas negative responses following both treatments is likely to be seen in typical SUNCT patients.


Deep Brain Stimulation Cluster Headache Trigeminal Neuralgia Autonomic Symptom Paroxysmal Hemicrania 
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Copyright information

© Lifting The Burden 2011

Authors and Affiliations

  • Henrik Winther Schytz
    • 1
  • Cristina Tassorelli
    • 2
  • Messoud Ashina
    • 1
  1. 1.Danish Headache Centre and Department of NeurologyGlostrup Hospital, University of CopenhagenGlostrupDenmark
  2. 2.Headache Science Centre, IRCCS “Neurological Institute C. Mondino” FoundationUniversity Consortium for Adaptive Disorders and Head Pain (UCADH), University of PaviaPaviaItaly

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