Trigeminal Autonomic Cephalgia (TACs)

Symptoms of Paroxysmal Hemicrania

• Severe, one-sided headache pain.
• Each headache attack usually lasts between 2 to 30 minutes.
• The pain is often around your eye, temple, or forehead.
• Paroxysmal Hemicrania includes either or both of the following.

1. At least one of the following symptoms or signs, on the same side of the pain:
   • Red or watery eye
   • Runny or blocked nose
   • Drooping eyelid or smaller pupil
   • Swelling of the eye or forehead
2. A sense of restlessness or agitation

Who Gets Paroxysmal Hemicrania?

• Paroxysmal Hemicrania is rare, but it can affect anyone.
• It is more common in women than men.
• Most people are diagnosed between the ages of 30 and 50.

How is Paroxysmal Hemicrania Diagnosed?

To diagnose Paroxysmal Hemicrania, doctors will ask about your symptoms and do a physical exam. They may also use tests, such as brain scans, to rule out other conditions.

This is important because Paroxysmal Hemicrania can sometimes be confused with other types of headaches or neurological problems. Therapeutic trial with indomethacin (a specific type of non-steroidal anti-inflammatory drug) can help to reach a diagnosis.

Treatment for Paroxysmal Hemicrania

• Medications: The most common treatment for Paroxysmal Hemicrania is a type of Non- Steroidal Anti-Inflammatory medication called indomethacin, which can
• stop attacks and reduce their frequency.
• Other medications: Sometimes, other medications like pain relievers or preventive treatments may be used to help manage the condition.
• Lifestyle changes: In some cases, stress management and avoiding triggers can help reduce the number of attacks.

For more information, speak to your doctor or contact Migraine Ireland’s Infoline service

Symptoms of Hemicrania Continua

• Constant pain: The headache persists all day, every day, for at least 3 months. The pain is usually on one side of the head.
• Pain intensity:The pain is characterised by a constant baseline pain of low to moderate intensity and accompanied by exacerbations of moderate or greater intensity pain.
• Eye involvement: The headache can cause discomfort around or behind one eye. – the same location as paroxysmal hemicrania. [Theodoros1]

Associated symptoms:

Hemicrania Continua includes either or both of the following

• At least one of the following symptoms or signs, on the same side of the pain:
  • Red or watery eye
  • Runny or blocked nose
  • Drooping eyelid or smaller pupil
  • Swelling of the eye or forehead

• A sense of restlessness or agitation

Treatment

• Indomethacin: This  Non-Steroidal Anti-Inflammatory drug is the first treatment choice. It is highly effective for most people with hemicrania continua.
• Other medications: If indomethacin does not work, other treatments may include different pain relievers or medications used to treat migraine.

Living with Hemicrania Continua

While hemicrania continua is a long-term condition, it can be managed with proper treatment.

It’s important to work with your doctor to find the right medication to keep the pain under control. Support groups and lifestyle adjustments, such as stress management and avoiding known headache triggers, can help improve quality of life.

What is SUNCT Syndrome?

SUNCT (Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing) is a rare, severe headache disorder that causes intense pain, on one side of the head.

This condition can last anywhere from 1 second  to about 10 minutes but can occur in clusters. The pain is often described as sharp and stabbing or saw-tooth pattern pain, affecting the eye and surrounding areas.

What is SUNA?

SUNA (Short-lasting Unilateral Neuralgiform headache attacks with Autonomic symptoms) is similar to SUNCT but involves additional autonomic symptoms, such as nasal congestion, eye redness, or tearing.

SUNA is also a rare condition and tends to be short-lived but very intense.

Symptoms of SUNCT & SUNA:

1. Pain Characteristics:
   • Intense, stabbing pain on one side of the head, often near or around the eye or temple.
   • The pain can last from a few seconds to a few minutes, but come in frequent clusters – Attacks can number 3 – 200 per day.

1. Autonomic Symptoms:
   • For both SUNCT/SUNA at least one of the following five symptoms or signs is present, on the same side of the pain:
     • Red or watery eye
     • Runny or blocked nose
     • Drooping eyelid or smaller pupil
     • Swelling of the eye
     • Forehead of facial flushing
     • Forehead and facial flushing
     • Sensation of fullness in the ear
   • For SUNCT, tearing and redness in the eye are common.
   • For SUNA, only one or neither of tearing and redness is present.

How is SUNCT & SUNA Diagnosed?

Doctors use a combination of clinical evaluation, medical history, and imaging tests to diagnose SUNCT and SUNA. A detailed description of the symptoms is crucial, especially the frequency, duration, and type of pain experienced. In some cases, doctors may also conduct brain scans to rule out other conditions.

Although these conditions can be debilitating, with the right treatment and management plan, most people can experience significant relief from symptoms. It is important to work closely with a healthcare provider to determine the best course of action for your specific situation.

By staying proactive—tracking your triggers, maintaining a regular routine, and managing stress—you can significantly reduce the impact of these painful attacks. With the right treatment plan and collaboration with healthcare professionals, you can maintain control and improve your quality of life.