Trigeminal Autonomic Cephalalgias Definition, Symptoms, Causes, Treatment

It is not a simple disease to understand because it is the group of different headache disorders. In this condition, headache involves the whole side of face. Pain may be moderate or severe unilateral involving head and face. The associated features include conjunctival injection, lacrimation, ptosis, eyelid edema and nasal congestion. The headache disorders have different duration and frequency of attacks. Cluster headache is the type of headache disorders which have longer duration than all other types and it is also less frequent than others. Contrary to it, short acting neuralgiform headache and paroxysmal hemicrania have less duration but are very frequent.

The group of headache disorders contains the following:

• Cluster headache: it is the most common headache disorder which occurs in almost 0.1 percent of cases. Male are at higher risk.
• Episodic and chronic cluster headache: in about 90 percent of cases, cluster headache occurs in the form of episodes. it has longer duration from days to months.  It can reoccur with the average gap of months and years.
• Paroxysmal hemicrania: this disorder is more frequent i.e. occurs 4 to 5 times a day but last for 20 to 30 minutes.
• Short lasting unilateral neuralgiform headache: the attack persists for about 600 seconds and is known as most frequent.

Trigeminal Autonomic Cephalalgia Symptoms

As it's definition tells that it is a group of headache disorders so headache is the primary and common symptom. Pain does not only occur in head region, but face is also involved. Pain occurs on one side of head and face. Sometimes it is bilateral. The associated features of trigeminal autonomic cephalalgia are excessive lacrimation, rhinorrhea, conjunctival injection, ptosis, nasal congestion and eyelid edema. Other symptoms are according to every type of headache disorder. Like grittiness or itching occurs in eye in case of hemicrania continua.

Trigeminal Autonomic Cephalalgia Causes

In trigeminal autonomic cephalalgia, the posterior hypothalamus region is activated. This activation is specific in cluster headache, short lasting unilateral neuralgiform headache and paroxysmal hemicrania. Locus ceruleus, dorsal pons and periaqueductal gray matter are the main areas involved in migraine. The striking in trigeminal autonomic cephalalgia is tha is the autonomic component which accompany each attack. The autonomic symptoms are considered normal physiological response. Basically trigeminal nerve compression is responsible for trigeminal autonomic cephalalgia. The dis inhibition of trigeminal autonomic reflex and hypothalamic direct modulation pathway named trigeminovascular nociceptive are considered the main causes.

Trigeminal Autonomic Cephalalgia Treatment

There are two main treatment strategies I.e. non pharmacological and pharmacological. In non pharmacological treatment involve the following:

• Greater occipital nerve injection: the trigeminocervical complex is modulated. This system is either blocked or stimulated to reduce pain. A steroid injection or local anesthetics injection are used in treatment of headache.
• Occipital nerve stimulation: there is a bit acute abortive effect.
• In hypothalamic deep brain stimulation, the posterior side of hypothalamus is stimulated and this stimulation give positive results.
• Every type of headache disorder in trigeminal autonomic cephalalgia show different response to all the above mentioned treatment strategies.