Trigeminal Autonomic Cephalalgias (TACs): Headaches and Types

Trigeminal Autonomic Cephalalgias (TACs) are highly interesting to me: This group of unilateral, excruciating primary headaches is accompanied by ipsilateral cranial autonomic symptoms and comprises of three major forms:

1. Cluster Headache (CH)

2. Paroxysmal Hemicrania (PH)

3. Short unilateral neuralgiform headache (with conjunctival injection and tearing and cranial autonomic symptoms) (SUNCT/SUNA)

The borders between the different forms are very fluid and the specific conditions are often misdiagnosed as a strong migraine, causing the patients to suffer significant pain before treatment is started. Which directly links to another problem: The treatment. Oxygen treatment seems promising, yet it is not readily available to the patients. Orally administered triptans are usually too weak and nasally administered triptans (e.g. ZOMIG) cannot be used in a sufficient frequency to relieve the pain during the whole day, especially in the case of Paroxysmal Hemicrania where attacks are generally of shorter duration yet of higher intensity. Therefore, patients still need to resort to taking a significant amount of painkillers which is medically problematic since an attack period can last up to several months or even years in the case of chronic conditions which 10-15% of cluster headache patients suffer from.

The inadequate treatment and difficult diagnosis is a results of the uncertainty around the subject of TACs: They are still quite unresearched and while the connection with the trigeminal nerve is already made, the underlying cause for TACs remains unknown. There are currently two leads for the causes: Rafael Benoliel of the Hebrew University of Jerusalem found that that during an attack there is much more activity in the hypot...

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...ests, but also electroencephalographic tests that will show me precise brain activity. Furthermore, it is highly possible and very probable that this increase in IQ is not directly caused by the chemical species of alcohol but by the personality traits that lead to a higher alcohol consumption. Again, this would be very interesting to analyse with the help of electroencephalographic tests. At Hopkins, I would be able to seek mentorship from professors Mark P. Mattson, Hey-Kyoung Lee and Jay Baraban, experts in neurodegenerative diseases, synaptic plasticity and neuronal plasticity respectively. The guidance and opinions of these scientists will provide crucial help in my process of researching this topic.

Johns Hopkins is the place to be when it comes to research and I am certain that whatever I need in order to conduct my research, it will be available at Hopkins.