Continuum (Minneap Minn). 2024 Apr 1;30(2):391-410. doi: 10.1212/CON.0000000000001411.
This article reviews the epidemiology, clinical features, differential diagnosis, pathophysiology, and management of three types of trigeminal autonomic cephalalgias: cluster headache (the most common), short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA).
The first-line treatments for trigeminal autonomic cephalalgias have not changed in recent years: cluster headache is managed with oxygen, triptans, and verapamil, and SUNCT and SUNA are managed with lamotrigine. However, new successful clinical trials of high-dose prednisone, high-dose galcanezumab, and occipital nerve stimulation provide additional options for patients with cluster headache. Furthermore, new genetic and imaging tests in patients with cluster headache hold promise for a better understanding of its pathophysiology.
The trigeminal autonomic cephalalgias are a group of diseases that appear similar to each other and other headache disorders but have important differences. Proper diagnosis is crucial for proper treatment.
本文综述了三种三叉神经自主神经性头痛的流行病学、临床特征、鉴别诊断、病理生理学和治疗方法：丛集性头痛（最常见）、短暂单侧神经痛样头痛伴结膜充血和流泪（SUNCT）以及短暂单侧神经痛样头痛伴颅自主神经症状（SUNA）。
近年来，三叉神经自主神经性头痛的一线治疗方法没有改变：丛集性头痛采用吸氧、曲普坦类药物和维拉帕米治疗，SUNCT 和 SUNA 采用拉莫三嗪治疗。然而，高剂量泼尼松、高剂量加奈珠单抗和枕神经刺激的新临床试验为丛集性头痛患者提供了更多的治疗选择。此外，丛集性头痛患者的新基因和影像学检测有望更好地了解其病理生理学。
三叉神经自主神经性头痛是一组表现相似的疾病，与其他头痛障碍有重要区别。正确的诊断对于正确的治疗至关重要。
