[Trigeminal autonomic cephalgias - new aspects and concepts]

Abstract

Cluster headache, paroxysmal hemicrania and SUNCT syndrome are a group of primary headaches classified as "trigeminal autonomic cephalgias" (TACs) and characterised by relatively short attacks of unilateral head pain associated with ipsilateral craniofacial autonomic manifestations. Duration of attacks is the main feature to distinguish between the three forms of TACs. Modern functional neuroimaging indicates that the hypothalamus may play a crucial role in the pathophysiology of these headaches. Therapeutic regimes consist of acute treatment as well as application of prophylactic medication. After unsuccessful application of conservative treatment options, invasive neuromodulative procedures are finally justified. These treatments should be rather of neurostimulative than of neurodestructive intentions.