What should you know about trigeminal autonomic headache?

The trigeminal nerve carries facial sensation, while the autonomic symptoms involve automatic nerve activity. During an attack, pain may occur around the eye, temple or forehead, with tearing, eye redness, a blocked or runny nostril, eyelid drooping or facial sweating on the painful side. Attacks can recur in a recognisable pattern, but several headache disorders and other conditions can look similar. A symptom diary helps a clinician assess timing, triggers and associated signs.

Arrange a clinical assessment for new, repeated or unusually severe attacks. Record when pain starts, how long it lasts, which side is affected, eye or nose changes, medicines taken and possible triggers such as alcohol or disrupted sleep. Rest in a safe place and avoid driving during an attack. Do not rely on repeated over-the-counter painkillers without advice, because frequent use can worsen headache patterns.

Seek emergency help for a sudden explosive headache, new weakness, trouble speaking, seizure, fainting, confusion, fever with a stiff neck, vision loss or a painful red eye. Prompt assessment is also needed when the pattern is new, changes quickly, follows a head injury or occurs with pregnancy or serious illness.

Ask whether your pattern fits a trigeminal autonomic headache, whether examination or imaging is needed, and which acute and preventive treatments are suitable. Discuss warning signs and how to track attacks.