Subscribe to RSS
DOI: 10.1055/s-0042-1758043
Recent Advances and Updates in Trigeminal Autonomic Cephalalgias
![](https://www.thieme-connect.de/media/sin/202204/lookinside/thumbnails/10-1055-s-0042-1758043_20220032-1.jpg)
Abstract
Trigeminal autonomic cephalalgias (TACs) are discrete primary headache disorders, characterized by severe unilateral head pain, typically trigeminal distribution, with ipsilateral cranial autonomic symptoms. The conditions within this group are hemicrania continua, cluster headache, paroxysmal hemicrania, and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing and short-lasting unilateral neuralgiform headache with autonomic symptoms. Several advances have been made in understanding the pathogenesis and evolving treatment options in TACs. This review will outline the advances and updates in each TAC.
Keywords
trigeminal autonomic cephalalgia - cluster headache - paroxysmal hemicrania - hemicrania continua - SUNCT/SUNA/SUNHADisclosures
D.Y.W.: none.
P.J.G. reports, over the last 36 months, grants and personal fees from Eli-Lilly and Company; grant from Celgene; and personal fees from Aeon Biopharma, Allergan/Abbvie, Amgen, Biodelivery Sciences International, Biohaven Pharmaceuticals Inc., CoolTech LLC, Dr Reddys, Epalex, Impel Neuropharma, Lundbeck, Novartis, Praxis, Sanofi, Satsuma, and Teva Pharmaceuticals; personal fees for advice through Gerson Lehrman Group, Guidepoint, SAI Med Partners, Vector Metric; fees for educational materials from CME Outfitters, Omnia Education, WebMD; publishing royalties or fees from Massachusetts Medical Society, Oxford University Press, UptoDate, and Wolters Kluwer; and for medicolegal advice in headache, and a patent magnetic stimulation for headache (no. WO2016090333 A1) assigned to eNeura without fee.
Publication History
Article published online:
02 November 2022
© 2022. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Headache Classification Committee of the International Headache Society (IHS). Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018; 38 (01) 1-211
- 2 Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013; 33 (09) 629-808
- 3 Goadsby PJ, Edvinsson L. Human in vivo evidence for trigeminovascular activation in cluster headache. Neuropeptide changes and effects of acute attacks therapies. Brain 1994; 117 (Pt 3): 427-434
- 4 Goadsby PJ, Dodick DW, Leone M. et al. Trial of galcanezumab in prevention of episodic cluster headache. N Engl J Med 2019; 381 (02) 132-141
- 5 Dodick DW, Goadsby PJ, Lucas C. et al. Phase 3 randomized, placebo-controlled study of galcanezumab in patients with chronic cluster headache: results from 3-month double-blind treatment. Cephalalgia 2020; 40 (09) 935-948
- 6 Silberstein SD, Mechtler LL, Kudrow DB. et al; ACT1 Study Group. Non-invasive vagus nerve stimulation for the ACute treatment of cluster headache: findings from the randomized, double-blind, sham-controlled ACT1 study. Headache 2016; 56 (08) 1317-1332
- 7 Goadsby PJ, de Coo IF, Silver N. et al; ACT2 Study Group. Non-invasive vagus nerve stimulation for the acute treatment of episodic and chronic cluster headache: a randomized, double-blind, sham-controlled ACT2 study. Cephalalgia 2018; 38 (05) 959-969
- 8 de Coo IF, Marin JC, Silberstein SD. et al. Differential efficacy of non-invasive vagus nerve stimulation for the acute treatment of episodic and chronic cluster headache: a meta-analysis. Cephalalgia 2019; 39 (08) 967-977
- 9 Bahra A, Goadsby PJ. Diagnostic delays and mis-management in cluster headache. Acta Neurol Scand 2004; 109 (03) 175-179
- 10 Frederiksen HH, Lund NL, Barloese MC, Petersen AS, Jensen RH. Diagnostic delay of cluster headache: a cohort study from the Danish Cluster Headache Survey. Cephalalgia 2020; 40 (01) 49-56
- 11 Rozen TD, Fishman RS. Cluster headache in the United States of America: demographics, clinical characteristics, triggers, suicidality, and personal burden. Headache 2012; 52 (01) 99-113
- 12 Kim B-S, Chung P-W, Kim B-K. et al. Diagnostic delay and its predictors in cluster headache. Front Neurol 2022; 13: 827734
- 13 Kunkle EC, Pfeiffer Jr JB, Wilhoit WM, Hamrick Jr LW. Recurrent brief headache in cluster pattern. Trans Am Neurol Assoc 1952; 56 (77th Meeting): 240-243
- 14 Friedman AP, Mikropoulos HE. Cluster headaches. Neurology 1958; 8 (09) 653-663
- 15 Blau JN, Engel HO. Premonitory and prodromal symptoms in cluster headache. Cephalalgia 1998; 18 (02) 91-93 , discussion 71–72
- 16 Snoer A, Lund N, Beske R, Hagedorn A, Jensen RH, Barloese M. Cluster headache beyond the pain phase: a prospective study of 500 attacks. Neurology 2018; 91 (09) e822-e831
- 17 Wei DY, Goadsby PJ. Comprehensive clinical phenotyping of nitroglycerin infusion induced cluster headache attacks. Cephalalgia 2021; 41 (08) 913-933
- 18 Cohen AS, Burns B, Goadsby PJ. High-flow oxygen for treatment of cluster headache: a randomized trial. JAMA 2009; 302 (22) 2451-2457
- 19 Sumatriptan Cluster Headache Study Group. Treatment of acute cluster headache with sumatriptan. N Engl J Med 1991; 325 (05) 322-326
- 20 Wei DY, Goadsby PJ. Cluster headache pathophysiology - insights from current and emerging treatments. Nat Rev Neurol 2021; 17 (05) 308-324
- 21 Cohen AS, Matharu MS, Goadsby PJ. Electrocardiographic abnormalities in patients with cluster headache on verapamil therapy. Neurology 2007; 69 (07) 668-675
- 22 Gaul C, Diener HC, Silver N. et al; PREVA Study Group. Non-invasive vagus nerve stimulation for PREVention and acute treatment of chronic cluster headache (PREVA): a randomised controlled study. Cephalalgia 2016; 36 (06) 534-546
- 23 Fanciullacci M, Alessandri M, Figini M, Geppetti P, Michelacci S. Increase in plasma calcitonin gene-related peptide from the extracerebral circulation during nitroglycerin-induced cluster headache attack. Pain 1995; 60 (02) 119-123
- 24 Lipton RBDH, Barbanti P, Schiemann J. et al. Efficacy and safety of fremanezumab for the prevention of episodic cluster headache: results of a randomized, double-blind, placebo-controlled, phase 3 study. Cephalalgia 2019; 39 (1, Suppl): 358-359
- 25 Rubio-Beltrán E, Labastida-Ramírez A, Villalón CM, MaassenVanDenBrink A. Is selective 5-HT1F receptor agonism an entity apart from that of the triptans in antimigraine therapy?. Pharmacol Ther 2018; 186: 88-97
- 26 Lambru G, Rantell K, Levy A, Matharu MS. A prospective comparative study and analysis of predictors of SUNA and SUNCT. Neurology 2019; 93 (12) e1127-e1137
- 27 Weng HY, Cohen AS, Schankin C, Goadsby PJ. Phenotypic and treatment outcome data on SUNCT and SUNA, including a randomised placebo-controlled trial. Cephalalgia 2018; 38 (09) 1554-1563
- 28 Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis. Brain 2001; 124 (Pt 12): 2347-2360
- 29 Maarbjerg S, Wolfram F, Gozalov A, Olesen J, Bendtsen L. Significance of neurovascular contact in classical trigeminal neuralgia. Brain 2015; 138 (Pt 2): 311-319
- 30 May A, Bahra A, Büchel C, Turner R, Goadsby PJ. Functional magnetic resonance imaging in spontaneous attacks of SUNCT: short-lasting neuralgiform headache with conjunctival injection and tearing. Ann Neurol 1999; 46 (05) 791-794
- 31 Cohen AS. Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing. Cephalalgia 2007; 27 (07) 824-832
- 32 Black DF, Dodick DW. Two cases of medically and surgically intractable SUNCT: a reason for caution and an argument for a central mechanism. Cephalalgia 2002; 22 (03) 201-204
- 33 Sprenger T, Valet M, Platzer S, Pfaffenrath V, Steude U, Tolle TR. SUNCT: bilateral hypothalamic activation during headache attacks and resolving of symptoms after trigeminal decompression. Pain 2005; 113 (03) 422-426
- 34 Lambru G, Lagrata S, Levy A. et al. Trigeminal microvascular decompression for short-lasting unilateral neuralgiform headache attacks. Brain 2022; 145 (08) 2882-2893
- 35 Tso AR, Marin J, Goadsby PJ. Noninvasive vagus nerve stimulation for treatment of indomethacin-sensitive headaches. JAMA Neurol 2017; 74 (10) 1266-1267
- 36 González-Quintanilla V, Pérez-Pereda S, Fontanillas N, Pascual J. First case of hemicrania continua responsive to galcanezumab. Neurol Sci 2021; 42 (11) 4775-4776
- 37 Villar-Martínez MD, Moreno-Ajona D, Chan C, Goadsby PJ. Indomethacin-responsive headaches - a narrative review. Headache 2021; 61 (05) 700-714
- 38 Summ O, Andreou AP, Akerman S, Holland PR, Hoffmann J, Goadsby PJ. Differential actions of indomethacin: clinical relevance in headache. Pain 2021; 162 (02) 591-599
- 39 Möller M, Schröder C, Iwersen-Bergmann S, Mehnert J, May A. Indomethacin has no effect on trigeminally provoked parasympathetic output. Cephalalgia 2022; 42 (01) 37-43
- 40 Moncada S, Palmer RM, Higgs EA. Nitric oxide: physiology, pathophysiology, and pharmacology. Pharmacol Rev 1991; 43 (02) 109-142
- 41 Eberhardt M, Neeb L, Vogel EM. et al. Glycerol trinitrate facilitates stimulated CGRP release but not gene expression of CGRP or its receptor components in rat trigeminal ganglia. Neuropeptides 2009; 43 (06) 483-489
- 42 Tassorelli C, Joseph SA. Systemic nitroglycerin induces Fos immunoreactivity in brainstem and forebrain structures of the rat. Brain Res 1995; 682 (1-2): 167-181
- 43 Tassorelli C, Greco R, Wang D, Sandrini M, Sandrini G, Nappi G. Nitroglycerin induces hyperalgesia in rats – a time-course study. Eur J Pharmacol 2003; 464 (2-3): 159-162
- 44 Tesser-Viscaíno SA, Denadai-Souza A, Teixeira SA. et al. Putative antinociceptive action of nitric oxide in the caudal part of the spinal trigeminal nucleus during chronic carrageenan-induced arthritis in the rat temporomandibular joint. Brain Res 2009; 1302: 85-96
- 45 Afridi S, Kaube H, Goadsby PJ. Occipital activation in glyceryl trinitrate induced migraine with visual aura. J Neurol Neurosurg Psychiatry 2005; 76 (08) 1158-1160
- 46 Sances G, Tassorelli C, Pucci E, Ghiotto N, Sandrini G, Nappi G. Reliability of the nitroglycerin provocative test in the diagnosis of neurovascular headaches. Cephalalgia 2004; 24 (02) 110-119
- 47 Ekbom K. Nitroglycerin as a provocative agent in cluster headache. Arch Neurol 1968; 19 (05) 487-493