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Ann Indian Acad Neurol. 2018 Apr;21(Suppl 1):S39-S44. doi: 10.4103/aian.AIAN_348_17.

Overview of Trigeminal Autonomic Cephalalgias: Nosologic Evolution, Diagnosis, and Management.

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Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, United Kingdom.
NIHR-Wellcome Trust King's Clinical Research Facility, Kings College Hospital, London, United Kingdom.
Department of Medicine, Division of Neurology, National University Health System, University Medicine Cluster, Singapore.


The term trigeminal autonomic cephalalgias (TACs) encompasses four primary headache disorders - cluster headache, paroxysmal hemicrania (PH), hemicrania continua (HC), short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)/short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA). All of these except HC are characterized by short-lasting headaches. HC is characterized by a continuous unilateral headache that waxes and wanes in its intensity without complete resolution. It is included in the TACs group given the overlap in the activation of the posterior hypothalamic grey, and the shared clinical feature of unilateral head pain with ipsilateral cranial autonomic symptoms. The present review gives an overview of the nosologic evolution, diagnosis, and management of TACs.


Cluster headache; hemicrania continua; paroxysmal hemicrania; short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing; short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms; trigeminal autonomic cephalalgias

Conflict of interest statement

P.J. Goadsby reports personal fees from Allergan, Amgen, and Eli-Lilly and Company; and personal fees from Akita Biomedical, Alder Biopharmaceuticals, Cipla Ltd, Dr. Reddy's Laboratories, eNeura, Electrocore LLC, Novartis, Pfizer Inc, Quest Diagnostics, Scion, Teva Pharmaceuticals, Trigemina Inc., Scion; and personal fees from MedicoLegal work, Journal Watch, Up-to-Date, Massachusetts Medical Society, Oxford University Press; and in addition, Dr. Goadsby has a patent Magnetic stimulation for headache assigned, without fee, to eNeura.

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