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Trigeminal Autonomic Cephalgias for Clinicians

The trigeminal autonomic cephalalgias are a group of headache disorders with prominent autonomic features and a shared pathophysiology.

There are four trigeminal autonomic cephalalgias. Each disorder can be either episodic or chronic. The trigeminal autonomic cephalalgias are uncommon headache disorders. Therefore, there is a high misdiagnosis rate350,351 and few randomised-controlled treatment trials.

The clinical characteristics of the trigeminal autonomic cephalalgias as defined by the International Classification of Headache Disorders are based upon the published cases reports and series apart from cluster headache which has population-based data.

The trigeminal autonomic cephalalgias are: 

  • Cluster headache
  • Paroxysmal hemicrania
  • SUNCT/SUNA (Short-lasting neuralgiform attacks with conjunctival injection and tearing/Short-lasting neuralgiform attacks with cranial autonomic features)
  • Hemicrania continua

Cluster Headache

Clinical Features

Acute / Responsive Treatment

Prophylactic / Preventive Treatment

Paroxysmal Hemicrania


Hemicrania Continua