Trigeminal autonomic cephalalgias: frequency in a general neurology clinic setting

Cases of trigeminal autonomic cephalalgia seen in general neurology outpatient clinics by one consultant neurologist over a 4 year period (2004-2007 inclusive) were identified. A total of 40 cases was identified (=1.2% of all referrals, 5.3% of headache referrals), most with cluster headache, the remainder with SUNCT or SUNA. There was evidence of both delayed diagnosis and inappropriate treatment, despite involvement of other secondary care specialties. Increased awareness of this diagnostic category is required to ensure effective deployment of effective, evidence-based treatments.