Chen W H, Tseng Y L, Lui C C, Liu J S
Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, PR China.
Brain Inj. 2005 Oct;19(11):949-53. doi: 10.1080/02699050500109936.
Other than from the thalamus and sensory cortex, episodic pain is an extremely rare neurological manifestation in the central compartment. This study reports a middle-aged man who experienced an acute onset of episodic oscillatory burning pain restricted to the cheiro-oral region, who was found to have a singular infarct at the left tegmental pons. A close relationship between his pain attack and an elevation of arterial blood pressure was clearly observed. Blood adenohypophyseal hormones and electroencephalogram did not reveal an abnormality in the ictus. Neuroimaging and clinical studies did not support involvement of the thalamus, periaqueductal gray matter, hypothalamus or regional structure. Therefore, episodic pain may be an isolated manifestation with a pontine lesion. A relapsing expansion of focal cerebral oedema with fluid retention may have corresponded to the oscillation of his sensory deficit. This accumulating, devastating calamity by a repetitive and paroxysmal offense after a blood-brain barrier breakdown should be cautiously reviewed.
除了丘脑和感觉皮层外，发作性疼痛在中枢区域是一种极其罕见的神经学表现。本研究报告了一名中年男性，他突然发作发作性振荡性灼痛，局限于口手区域，发现其左侧脑桥被盖部有单个梗死灶。明显观察到他的疼痛发作与动脉血压升高之间存在密切关系。发作期血腺垂体激素和脑电图未显示异常。神经影像学和临床研究不支持丘脑、导水管周围灰质、下丘脑或区域结构受累。因此，发作性疼痛可能是桥脑病变的孤立表现。局灶性脑水肿伴液体潴留的复发性扩展可能与他的感觉障碍的振荡相对应。血脑屏障破坏后反复阵发性发作导致的这种累积性、毁灭性灾难应谨慎审视。
