Totzeck Andreas, Diener Hans-Christoph, Gaul Charly
Department of Neurology and Headache Center, University Hospital Essen, Germany.
Cephalalgia. 2014 Mar;34(3):231-5. doi: 10.1177/0333102413506127. Epub 2013 Sep 24.
The trigeminal autonomic cephalalgias (TACs) subsume four primary headache disorders. Hemicrania continua is increasingly regarded as an additional TAC. In rare cases patients may present with two different TACs or a TAC and hemicrania continua.
We report four patients with two different TACs or one TAC and hemicrania continua. Two patients presented with cluster headache and paroxysmal hemicrania, one patient with cluster headache and hemicrania continua, and one patient suffered from cluster headache and SUNCT.
While the International Classification of Headache Disorders (ICHD-II) proposes specific diagnostic criteria, the variability of clinical presentation may make clear diagnosis difficult. All patients fulfilled the ICHD-II criteria. The manifestation of two different TACs or hemicrania continua in one patient is uncommon but possible and should be taken into account especially when chronic headache patients present with changing headache symptoms.
三叉自主神经性头痛（TACs）包含四种主要的头痛疾病。持续性偏侧头痛越来越被视为另一种TAC。在罕见情况下，患者可能同时出现两种不同的TAC，或一种TAC与持续性偏侧头痛。
我们报告了4例患者，他们患有两种不同的TAC，或一种TAC与持续性偏侧头痛。2例患者表现为丛集性头痛和发作性偏侧头痛，1例患者为丛集性头痛和持续性偏侧头痛，1例患者患有丛集性头痛和短时间单侧神经痛性头痛发作伴结膜充血及流泪综合征（SUNCT）。
虽然《国际头痛疾病分类》（ICHD-II）提出了具体的诊断标准，但临床表现的变异性可能使明确诊断变得困难。所有患者均符合ICHD-II标准。一名患者出现两种不同的TAC或持续性偏侧头痛的情况并不常见，但有可能发生，尤其是当慢性头痛患者出现头痛症状变化时，应予以考虑。
