1 Neurology Department, Hospital de Santo António, CHP - Centro Hospitalar do Porto, Porto, Portugal.
2 Neuroradiology Department, Hospital de Santo António, CHP - Centro Hospitalar do Porto, Porto, Portugal.
Cephalalgia. 2019 Apr;39(5):674-677. doi: 10.1177/0333102418815652. Epub 2018 Nov 27.
Short-lasting unilateral neuralgiform headaches include those with conjunctival injection and tearing and with cranial autonomic symptoms. Most frequently reported as idiopathic, there is a growing number of symptomatic cases described.
A 57-year old man presented a 16-year history of right hemifacial short-lasting pain attacks accompanied by ipsilateral autonomic symptoms and simultaneous malar contractions. Brain MRI disclosed a right acoustic neuroma compressing the right facial nerve and a venous developmental anomaly perpendicular to the right facial nerve root entry zone, without lesions affecting the trigeminal nerve. He was started on lamotrigine, resulting in complete remission of pain attacks, autonomic signs and facial contractions.
This patient presents a typical short-lasting unilateral neuralgiform headache with response to lamotrigine. The uniqueness of the case is the co-occurring malar contractions, evocative of facial nerve involvement. We speculate whether facial nerve compression renders this nerve more susceptible to triggering during a short-lasting unilateral neuralgiform headache attack.
短暂单侧神经性头痛包括伴有结膜充血和流泪以及颅自主神经症状的头痛。大多数被报道为特发性头痛，也有越来越多的症状性病例被描述。
一名 57 岁男性出现右侧面部短暂性疼痛发作 16 年，伴有同侧自主神经症状和同时出现的颧骨收缩。脑部 MRI 显示右侧听神经瘤压迫右侧面神经和垂直于右侧面神经根进入区的静脉发育异常，没有影响三叉神经的病变。他开始服用拉莫三嗪，疼痛发作、自主神经症状和面肌收缩完全缓解。
该患者表现为典型的短暂单侧神经性头痛，对拉莫三嗪有反应。该病例的独特之处在于同时出现的颧骨收缩，提示面神经受累。我们推测面神经受压是否使该神经在短暂单侧神经性头痛发作时更容易被触发。
