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Headaches with (ipsilateral) autonomic symptoms.

Arne May1

  • 1Dept. of Neurology, University of Regensburg, 93053, Regensburg, Germany. arne.may@klinik.uni-regensburg.de

Journal of Neurology
|December 4, 2003
PubMed
Summary

Short-lasting headaches are classified by autonomic symptoms. Trigemino-autonomic cephalgias, like cluster headaches, feature intense, unilateral pain and autonomic dysfunction, responding to specific treatments.

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Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Primary short-lasting headaches are categorized into trigemino-autonomic cephalgias (TACs) and those lacking significant autonomic symptoms.
  • TACs, including cluster headache and paroxysmal hemicranias, are characterized by severe head pain and prominent cranial autonomic dysfunction.
  • Cluster headache exhibits distinct circadian and circannual periodicity, with potential familial inheritance patterns.

Purpose of the Study:

  • To delineate the characteristics and classifications of primary short-lasting headaches.
  • To highlight the clinical features and treatment strategies for trigemino-autonomic cephalgias.
  • To explore the diagnostic significance of indomethacin responsiveness in certain headache types.

Main Methods:

  • Review and classification of primary short-lasting headache disorders based on clinical presentation.
  • Analysis of key features distinguishing TACs, such as periodicity, intensity, and autonomic symptoms.
  • Evaluation of treatment responses, particularly the efficacy of indomethacin in specific headache syndromes.

Main Results:

  • Trigemino-autonomic cephalgias are defined by unilateral, severe head pain accompanied by autonomic symptoms.
  • Cluster headache attacks show remarkable circadian and circannual patterns and respond to acute and prophylactic treatments.
  • Paroxysmal hemicrania and hemicrania continua demonstrate a significant therapeutic response to indomethacin.

Conclusions:

  • Primary short-lasting headaches are clinically heterogeneous, with TACs representing a distinct subgroup.
  • Effective management of TACs involves both acute attack termination and prophylactic strategies.
  • The pronounced response to indomethacin in paroxysmal hemicrania and hemicrania continua suggests a specific pathophysiological basis and aids in diagnosis.

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