[Autonomic Disorders in Trigeminal Autonomic Cephalalgias: An Update]

Area of Science:

• Neurology
• Headache Medicine

Background:

• Trigeminal Autonomic Cephalalgias (TACs) encompass several headache disorders, including cluster headache and paroxysmal hemicrania.
• TACs are defined by unilateral headache and distinct cranial parasympathetic autonomic features.

Purpose of the Study:

• To review the classification, clinical features, and potential pathophysiological mechanisms of TACs.
• To highlight the utility of the "Clinical Practice Guideline for Headache 2021 (Japanese version)" for TACs management.

Main Methods:

• Review of the International Classification of Headache Disorders (ICHD) criteria for TACs.
• Analysis of common clinical presentations and associated autonomic symptoms.
• Discussion of current hypotheses regarding TACs pathophysiology.

Main Results:

• TACs share features of unilateral headache with prominent ipsilateral autonomic symptoms like lacrimation, nasal congestion, eyelid edema, and sweating.
• The Japanese version of the 2021 Headache Clinical Practice Guideline offers guidance for TACs diagnosis and treatment.

Conclusions:

• TACs represent a distinct group of primary headaches requiring specific diagnostic and therapeutic approaches.
• Further research is needed to fully elucidate the complex pathophysiological mechanisms underlying TACs.