Headache & Facial Pain Specialist, Singapore
TRIGEMINAL AUTONOMIC CEPHALALGIAS

Trigeminal Autonomic Cephalalgias (TACs) represent a group of primary headache disorders characterized by excruciating pain in the head, accompanied by autonomic symptoms affecting the eyes, nose, and face.

These conditions, including Cluster Headache, Paroxysmal Hemicrania, and Short-lasting Unilateral Neuralgiform Headache Attacks with Conjunctival Injection and Tearing (SUNCT), present significant challenges for both patients and healthcare providers due to their intensity and complexity.

Symptoms of Trigeminal Autonomic Cephalalgias
TACs are among the most severe forms of primary headaches, often described by patients as "suicidal headaches" due to their intensity. The hallmark of TACs is the combination of severe, unilateral head pain with autonomic symptoms. The pain tends to be sharp, stabbing, or piercing and is typically localized to one side of the head. Alongside the pain, patients often experience autonomic symptoms such as tearing, nasal congestion, ptosis (drooping eyelid), and eye redness. These autonomic symptoms distinguish TACs from other primary headache disorders and play a crucial role in their diagnosis.

Impact on Patients
The severity and unpredictability of the attacks can disrupt daily activities, including work, social interactions, and sleep. Many patients report feelings of isolation, anxiety, and depression due to the chronic nature of their condition and the challenges associated with managing symptoms. It is common for patients to see multiple doctors before a diagnosis of TACs is made.

Diagnosis of Trigeminal Autonomic Cephalalgia
Diagnosing TACs requires a thorough evaluation by a Headache Specialist. A headache specialist is usually a Pain Specialist or Neurologist with an interest in the management of headaches.  

The diagnostic process typically involves a detailed medical history review, physical examination. Additional tests, such as imaging studies may be performed to rule out other conditions.

Treatment of Trigeminal Autonomic Cephalalgias
The treatment of TACs depends on the type of TAC. In general, the treatment strategies for TACs aim to reduce the frequency and severity of headache attacks, alleviate associated symptoms, and improve patients' quality of life.

Acute treatments, including abortive medications such as triptans and oxygen therapy, are used to manage individual headache attacks. Preventive therapies, such as calcium channel blockers, corticosteroids, and antiepileptic drugs, may be prescribed to reduce the frequency and severity of attacks over time. In some cases, interventional procedures, including nerve blocks may be considered for patients with refractory TACs.


Trigeminal Autonomic Cephalalgias (TACs) represent a complex and challenging group of headache disorders characterized by severe head pain and autonomic symptoms. The impact of TACs on patients' lives can be profound, underscoring the importance of accurate diagnosis, comprehensive care, and ongoing support. By understanding the nuances of TACs and implementing personalized treatment strategies, healthcare providers can help patients effectively manage their symptoms and improve their overall quality of life.
If you or someone you know is experiencing symptoms of TACs, don't hesitate to seek medical attention from a qualified healthcare professional. With the right diagnosis and treatment, relief is possible, and patients can regain control over their lives despite the challenges posed by TACs.