부산대학교 도서관

Trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders that share clinical and pathophysiological features. They are characterized by attacks of strictly unilateral head pain and ipsilateral autonomic features, resulting from excessive activity in the peripheral trigeminal system and its central connections, an augmented trigeminovascular reflex, prominent parasympathetic output, and sympathetic deficit. The four disorders—cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks (SUNHA), and hemicrania continua—are clinically distinguished on the basis of attack duration and frequency, with the attacks becoming shorter and more frequent from cluster headache to SUNHA. Hemicrania continua and paroxysmal hemicrania are diagnosed by their complete response to indomethacin. Hemicrania continua stands apart from other TACs with its continuous nature of pain and severe exacerbations. Treatment strategies across the four TACs differ considerably both for acute attacks and prophylaxis.