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Chapter 015. Headache (Part 14)

Table Cephalalgias 15-8 Clinical Features of the Trigeminal Autonomic Cluster Headache Paroxysmal Hemicrania SUNCT Gender MF F=M F~M Pain Type boring Stabbing, Throbbing, boring, stabbing Burning, stabbing, sharp Severity Excruciating Excruciating Severe excruciating to Site Orbit, temple Orbit, temple Periorbital Attack frequency 1/alternate day– 8/d 1–40/d (5/d for more than half the time) 3–200/d Duration attack of 15–180 min 2–30 min 5–240 s Autonomic features Yes Yes Yes (prominent conjunctival injection lacrimation)a and Migrainous featuresb Yes Yes Yes Alcohol trigger Yes No No Cutaneous triggers No No Yes Indomethaci n effect — Yesc — Abortive treatment Sumatriptan No effective (IV) Lidocaine injection or nasal treatment spray Oxygen Prophylactic treatment Verapamil n Methysergid Indomethaci e Lamotrigin e Topiramate Lithium Gabapentin . | Chapter 015. Headache Part 14 Table 15-8 Clinical Features of the Trigeminal Autonomic Cephalalgias Cluster Headache Paroxysmal Hemicrania SUNCT Gender M F F M F M Pain Type Stabbing boring Throbbing boring stabbing Burning stabbing sharp Severity Excruciating Excruciating Severe to excruciating Site Orbit temple Orbit temple Periorbital Attack frequency 1 alternate day- 8 d 1-40 d 5 d for more than half the time 3-200 d Duration of attack 15-180 min 2-30 min 5-240 s Autonomic features Yes Yes Yes prominent conjunctival injection and lacrimation Migrainous features Yes Yes Yes Alcohol trigger Yes No No Cutaneous triggers No No Yes Indomethaci n effect Yesc Abortive treatment Sumatriptan injection or nasal spray Oxygen No effective treatment Lidocaine IV Prophylactic treatment Verapamil Methysergid Indomethaci n Lamotrigin