Auffenberg Eva, Bender Friedemann, Freilinger Tobias
Department of Neurology and Epileptology, Hertie-Institute for Clinical Brain Research (HIH), Tübingen, Germany.
Department of Neurodegeneration, Hertie-Institute for Clinical Brain Research (HIH), Tübingen, Germany.
Case Rep Neurol. 2018 Mar 27;10(1):83-87. doi: 10.1159/000487881. eCollection 2018 Jan-Apr.
Hemicrania continua (HC) is a rare primary headache disorder, characterized by persistent unilateral pain associated with cranial autonomic symptoms and prompt response to indomethacin. While migrainous features (including aura) have been recognized in cluster headache, there have been only single reports of HC with aura. Here, we report the case of a 53-year-old man with constant right-sided headache and superimposed exacerbations to severe pain lasting for several hours. Secondary etiologies were excluded, and a diagnosis of HC was established after prompt and complete response to treatment with indomethacin. During an episode of pain exacerbation, for the first time the patient experienced an episode of transient visual disturbances compatible with scintillating scotoma. We propose a potential link between HC and visual aura, which parallels similar observations in other trigeminal autonomic cephalalgias and more specifically confirms previous observational data on aura in HC, thus highlighting potentially shared pathophysiological mechanisms.
慢性偏侧头痛（HC）是一种罕见的原发性头痛疾病，其特征为持续性单侧疼痛并伴有颅自主神经症状，且对吲哚美辛反应迅速。虽然丛集性头痛中已认识到偏头痛特征（包括先兆），但仅有关于HC伴先兆的个别报道。在此，我们报告一例53岁男性患者，其右侧头痛持续存在，并叠加有持续数小时的严重疼痛加剧发作。排除了继发性病因，在用吲哚美辛治疗后迅速且完全缓解，从而确诊为HC。在一次疼痛加剧发作期间，患者首次经历了一次与闪烁暗点相符的短暂视觉障碍发作。我们提出HC与视觉先兆之间可能存在联系，这与其他三叉神经自主性头痛的类似观察结果相似，更具体地证实了先前关于HC先兆的观察数据，从而突出了潜在的共同病理生理机制。
