Trigemino autonomic cephalalgia and Argyll Robertson pupil.

Dr. Marcio Balthazar – Rua Dr. Emílio Ribas 1587 / 51 13025-142 Campinas SP Brasil. E-mail: [email protected] The trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders characterized by short-lasting pain, often unilateral, with acompanying ipsilateral autonomic features like conjuntival injection, lacrimation, nasal congestion, rhinorrhea, ptosis or eyelid edema. The group comprises episodic and chronic cluster headache, chronic and episodic paroxysmal hemicrania, and SUNCT syndrome. SUNA syndrome (short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms), although not classified as a TAC, also shares some common characteristics with this group and may include the SUNCT definition. Despite their common elements, the TACs differ in response to therapy, frequency and duration of attacks. They must be differentiated from secundary TACs because of the possible serious and treatable underlying causes, like mass lesions, subarachnoid hemorrhage, pathology in the base of the skull and others. TACs are closely associated to pupillary abnormalities because of the common autonomic structures that control pupillary function and play a role in processing pain. Argyll Robertson pupil (ARP) is a rare kind of pupillary disturbance, most commonly seen in neurosyphilis, and its main feature is lack of reaction to light, with reaction to accommodation. We report a patient with ARP and features of a primary headache (classified as probable TAC) and discuss the possible relationship between these two conditions.