Salvesen R, Sand T, Zhao J M, Sjaastad O
Department of Neurology, Trondheim University Hospital, Norway.
Cephalalgia. 1989 Jun;9(2):131-8. doi: 10.1046/j.1468-2982.1989.0902131.x.
Fifty-three patients with cluster headache, mean age 42.6 years, were examined by means of pupillometry. Pharmacological stimulation was carried out by the instillation of eye drops; the sympathomimetic agents hydroxyamphetamine (a norepinephrine releaser) and phenylephrine (an agent acting directly on the postsynaptic receptors) were applied. Pupillary dilatation was measured at set time intervals, comparing the responses of the symptomatic and non-symptomatic sides. The material was divided into groups according to the degree of basal anisocoria. The subgroup with the most pronounced basal miosis of the symptomatic side demonstrated a uniform pattern of deficient symptomatic side dilatation after OH-amphetamine and supersensitivity to phenylephrine. The other groups demonstrated the same general pattern, but to a far lesser degree. In cluster headache, the extent of nonresponsiveness to OH-amphetamine and of phenylephrine supersensitivity on the symptomatic side thus, at least partly, seems to be a function of the degree of anisocoria. The response pattern in cluster headache seems to differ from that of 3rd neuron Horner's syndrome with an anisocoria of the same extent.
53例丛集性头痛患者，平均年龄42.6岁，接受了瞳孔测量检查。通过滴眼药水进行药理刺激；使用了拟交感神经药羟苯丙胺（一种去甲肾上腺素释放剂）和去氧肾上腺素（一种直接作用于突触后受体的药物）。在设定的时间间隔测量瞳孔扩张情况，比较有症状侧和无症状侧的反应。根据基础瞳孔不等大的程度将材料分组。有症状侧基础瞳孔缩小最明显的亚组在使用羟苯丙胺后表现出有症状侧扩张不足的一致模式，且对去氧肾上腺素超敏。其他组表现出相同的总体模式，但程度要小得多。因此，在丛集性头痛中，有症状侧对羟苯丙胺无反应的程度和对去氧肾上腺素超敏的程度至少部分似乎是瞳孔不等大程度的函数。丛集性头痛的反应模式似乎与同等程度瞳孔不等大的第三神经元霍纳综合征不同。
