Drummond P D
Department of Neurology, Prince Henry Hospital, University of N.S.W., Australia.
Headache. 1990 Jul;30(8):505-8. doi: 10.1111/j.1526-4610.1990.hed3008505.x.
The relationship between pain and autonomic disturbances in cluster headache was studied in 54 patients whose attack always recurred on the same side, and in 7 others whose attack had affected either side on different occasions. In one of these seven patients, facial flushing and ocular sympathetic deficit was observed on the original side of headaches. In most patients, the orbital region was warmer on the painful side but in three cases this region was cooler during and between attacks. Lacrimation and rhinorrhoea were more common in severe attacks, and the temperature difference between the orbits increased with increasing severity of pain. These findings support the view that certain autonomic disturbances in cluster headache are provoked by pain. Residual autonomic dysfunction could influence autonomic activity during cluster headache. If so, residual dysfunction on the pain-free side could explain the dissociation between autonomic disturbances and pain observed in a few cases.
对54例发作总是在同一侧反复出现的丛集性头痛患者以及另外7例发作在不同情况下累及双侧的患者，研究了疼痛与自主神经功能紊乱之间的关系。在这7例患者中的1例，在头痛的原侧观察到面部潮红和眼部交感神经功能缺损。在大多数患者中，疼痛侧的眶区温度较高，但有3例在发作期间及发作间歇期该区域温度较低。流泪和流涕在严重发作时更常见，且随着疼痛严重程度的增加，双侧眶区的温差增大。这些发现支持这样一种观点，即丛集性头痛中的某些自主神经功能紊乱是由疼痛诱发的。残留的自主神经功能障碍可能会影响丛集性头痛发作时的自主神经活动。如果是这样，无痛侧的残留功能障碍可以解释少数病例中观察到的自主神经功能紊乱与疼痛之间的分离现象。
