Abstract:
Trigeminal autonomic cephalgias (TACs) are a well-defined subset of uncommon primary headaches that share comparable onset, pathophysiology and symptom patterns. TACs are characterised by the presentation of one-sided and high-intensity trigeminal pain together with unilateral cranial autonomic signs, which can include lacrimation, rhinorrhea, and miosis. The International Classification of Headache Disorders 3rd Edition recognises four different headache entities in this group, with cluster headache as the most recognised among them. Hemicrania continua (HC) and paroxysmal hemicrania (PH) are both distinctive cephalgias of which the diagnostic criteria include an absolute response to indomethacin. Consequently, for this reason they are often referred to as \'indomethacin-responsive\' TACs. The main focus of this review was to discuss the state of knowledge regarding the pathophysiology and key characteristics of PH and HC. Given the limited understanding of these conditions, and their exceptionally uncommon prevalence, a correct diagnosis can pose a clinical challenge and the search for an effective treatment may be prolonged, which frequently has a serious impact upon patients\' quality of life. The information provided in this review is meant to help physicians to differentiate indomethacin-sensitive cephalgias from other distinct headache disorders with a relatively similar clinical presentation, such as cluster headache, trigeminal neuralgia, and various migraine conditions.
摘要:
三叉神经自主性头痛(TACs)是一个明确定义的不常见原发性头痛的子集,具有可比的发作,病理生理学和症状模式。TACs的特征是单侧和高强度三叉神经疼痛以及单侧颅骨自主神经体征。其中可以包括流泪,鼻漏,和瞳孔缩小。《国际头痛疾病分类第3版》识别了该组中的四种不同的头痛实体,丛集性头痛是其中最受认可的。连续性偏头痛(HC)和阵发性偏头痛(PH)都是独特的头颅,其诊断标准包括对吲哚美辛的绝对反应。因此,因此,它们通常被称为“吲哚美辛反应性”。这篇综述的主要重点是讨论有关PH和HC的病理生理学和关键特征的知识状况。鉴于对这些条件的理解有限,以及它们异常罕见的患病率,正确的诊断可能会带来临床挑战,寻找有效的治疗方法可能会延长,这往往对患者的生活质量产生严重影响。本综述提供的信息旨在帮助医生将吲哚美辛敏感的头颅与其他临床表现相对相似的明显头痛疾病区分开来。比如丛集性头痛,三叉神经痛,和各种偏头痛情况。