Document Detail


Symptomatic trigeminal autonomic cephalalgias.
MedLine Citation:
PMID:  19901708     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The trigeminal autonomic cephalalgias (TACs) are a group of primary headache syndromes characterized by strictly unilateral head pain that occurs in association with ipsilateral cranial autonomic features. The group includes cluster headache, paroxysmal hemicrania, and short lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing. These syndromes differ in attack duration and frequency as well as the response to therapy. Most of the cases of these syndromes are primary headaches, though numerous symptomatic cases have been described albeit that it is difficult to establish a causal relationship with the underlying pathology in most cases. REVIEW SUMMARY: We reviewed the literature to identify the cases of symptomatic TACs that were likely to be secondary to the reported underlying lesion. We also attempted to identify any clinical features that may be pointers for distinguishing these cases from primary cases and thereby inform the diagnostic workup of these disorders. CONCLUSION: Forty cases of symptomatic TACs were identified. These symptomatic headaches were associated with atypical phenotypes, abnormal examination, and poor treatment response though a significant minority had a typical presentation. A relatively high proportion of all TACs were secondary to pituitary tumors. It is difficult to draw up guidelines for the diagnostic workup required on the basis of this small retrospective case series. It remains unclear whether every TAC patient requires neuroimaging, though if it is considered then magnetic resonance imaging is the preferred modality. In addition, we suggest that all TAC patients should be carefully assessed for pituitary disease related symptoms but further investigations with magnetic resonance imaging of the pituitary gland and pituitary hormonal profile should only be undertaken in patients with atypical features, abnormal examination, or those resistant to the appropriate medical treatment.
Authors:
Elisabetta Cittadini; Manjit S Matharu
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The neurologist     Volume:  15     ISSN:  1074-7931     ISO Abbreviation:  Neurologist     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-10     Completed Date:  2010-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503763     Medline TA:  Neurologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  305-12     Citation Subset:  IM    
Affiliation:
From the Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Female
Functional Laterality / physiology*
Humans
Male
Middle Aged
Phenotype
Trigeminal Autonomic Cephalalgias / classification,  diagnosis*,  physiopathology*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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