Cefaleias autonômicas trigeminais: perspectivas atuais sobre fisiopatologia, diagnóstico e estratégias terapêuticas.
DOI:
https://doi.org/10.48208/HeadacheMed.2026.1Palavras-chave:
Cefaleias trigemino-autonômicas, Cefaleia em salvas, Hemicrania paroxística, Hemicrania contínua, SUNCT, SUNAResumo
Contexto
As cefaleias autonômicas trigeminais (CAT) são cefaleias primárias caracterizadas por dor craniofacial unilateral, geralmente periorbital ou temporal, acompanhada de sintomas autonômicos ipsilaterais, como lacrimejamento, congestão nasal, hiperemia conjuntival, miose e ptose. Incluem cefaleia em salvas, hemicrania paroxística, hemicrania contínua e crises de cefaleia neuralgiforme unilateral de curta duração (SUNCT e SUNA). O diagnóstico depende da duração, frequência e intensidade das crises, embora possa haver sobreposição clínica. A identificação precisa é crucial, pois o tratamento difere entre os subtipos. Compreender a fisiopatologia das CAT, particularmente a ativação autonômica trigeminal, é essencial para melhorar o diagnóstico, diferenciá-las de distúrbios semelhantes, como a migrânea, e otimizar o manejo terapêutico.
Resultados
As cefaleias autonômicas trigeminais representam um grupo de cefaleias primárias raras, porém incapacitantes, caracterizadas por vias fisiopatológicas sobrepostas que envolvem o hipotálamo e o reflexo trigemino-autonômico. Os avanços em neuroimagem e neuromodulação refinaram a compreensão dos mecanismos envolvidos e expandiram as opções terapêuticas além da farmacoterapia tradicional. O reconhecimento precoce e as intervenções personalizadas, baseadas nos mecanismos envolvidos, continuam sendo essenciais para a melhoria dos resultados.
Conclusões
Acreditamos ser muito importante e necessário oferecer uma revisão abrangente e atualizada das cefaleias autonômicas trigeminais, enfatizando suas características clínicas comuns e distintas, os mecanismos neurobiológicos subjacentes e as abordagens atuais baseadas em evidências para o diagnóstico e tratamento oportunos.
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Copyright (c) 2026 Marina Alejandra Olivier, Margareth Alexandra Contreras Martínez, Carlos Andrés Díaz Garza, Javier Andrés Galnares Olalde, Adolfo Leyva Rendon, Paula Alexandra Martínez Corredor, Verónica Lourdes Molina, María Celeste Rada Fernández, María Soledad Smechow, Osvaldo Carlos Jesús Bruera (Author)
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
