Diagnostic and therapeutic errors in trigeminal autonomic cephalalgias and hemicrania continua: a systematic review

The Journal of Headache and Pain

Review Article

Ottar Sjaastad¹  Marta Allena²  Michele Viana²  Giuseppe Nappi²  Fabio Antonaci³  Cristina Tassorelli³ 

[1] Department of Neurology, St. Olavs Hospital, Trondheim University Hospitals (NTNU), Trondheim, Norway;Headache Science Center-C. Mondino National Institute of Neurology Foundation, IRCCS, Via Mondino 2, 27100, Pavia, Italy;Headache Science Center-C. Mondino National Institute of Neurology Foundation, IRCCS, Via Mondino 2, 27100, Pavia, Italy;Department of Brain and Behaviour, University of Pavia, Pavia, Italy;

关键词: Cluster headache;    Paroxysmal hemicrania;    SUNCT;    Trigeminal autonomic cephalalgias;    Hemicrania continua;    Error;    Pitfall;    Misdiagnosis;    Mismanagement;   

DOI  :  10.1186/1129-2377-14-14

 received in 2013-01-02, accepted in 2013-02-09,  发布年份 2013

来源: Springer

【 摘 要 】

Trigeminal autonomic cephalalgias (TACs) and hemicrania continua (HC) are relatively rare but clinically rather well-defined primary headaches. Despite the existence of clear-cut diagnostic criteria (The International Classification of Headache Disorders, 2nd edition - ICHD-II) and several therapeutic guidelines, errors in workup and treatment of these conditions are frequent in clinical practice. We set out to review all available published data on mismanagement of TACs and HC patients in order to understand and avoid its causes. The search strategy identified 22 published studies. The most frequent errors described in the management of patients with TACs and HC are: referral to wrong type of specialist, diagnostic delay, misdiagnosis, and the use of treatments without overt indication. Migraine with and without aura, trigeminal neuralgia, sinus infection, dental pain and temporomandibular dysfunction are the disorders most frequently overdiagnosed. Even when the clinical picture is clear-cut, TACs and HC are frequently not recognized and/or mistaken for other disorders, not only by general physicians, dentists and ENT surgeons, but also by neurologists and headache specialists. This seems to be due to limited knowledge of the specific characteristics and variants of these disorders, and it results in the unnecessary prescription of ineffective and sometimes invasive treatments which may have negative consequences for patients. Greater knowledge of and education about these disorders, among both primary care physicians and headache specialists, might contribute to improving the quality of life of TACs and HC patients.

【 授权许可】

CC BY   
© Viana et al.; licensee Springer. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.