What are they?
Trigeminal autonomic cephalalgias (TACs) represent a group of headache disorders characterised by severe, unilateral head pain. We have written this blog here at the Brisbane Headache and Migraine Clinic, to give you a little bit of insight into these conditions.
The Trigeminal Nerve, responsible for sensation in the face and head, is implicated in these conditions. TACs include several distinct headache syndromes, such as cluster headache, paroxysmal hemicrania, and SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) and more.
TACs are are often associated with autonomic symptoms such as lacrimation (tears), nasal congestion, and eyelid drooping and eye redness. These headache syndromes are often debilitating and significantly impact patients’ quality of life, particularly as recurrence is common.
Diagnosis is typically based on clinical presentation, including the nature and pattern of headache attacks and associated autonomic symptoms. Though some TAC conditions, like cluster headaches, are known to be more common in men, anyone can experience them.
Short Term Relief
Medication for TACs aims to alleviate pain during acute attacks. There is good evidence to show to oxygen therapy can help significantly reduce pain with cluster headaches. Other medications that may be used are triptans , corticosteroids and in the case of paroxysmal hemicrania, indomethacin.
Long Term Solution
However, to help with long term management of these conditions, we must look a step further.
The root cause of TAC conditions can stem from the first three vertebrae of the neck, also known as the ‘upper cervical spine’. Factors such as head/neck injuries and poor posture are the most common contributors to changes in the cervical spine. This can then cause increased sensitivity of the surrounding nerves (e.g. the trigeminal nerve) and therefore cause pain to radiate to the head.
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