Neuro-Ophthalmology Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
Cephalalgia. 2020 Mar;40(3):313-316. doi: 10.1177/0333102419865974. Epub 2019 Jul 25.
Orbital myositis is an idiopathic, non-infectious condition, typically seen in young females and usually affecting one extraocular muscle. Orbital myositis mimicking cluster headache is a rare clinical entity, and this is the first description of a case of a secondary trigeminal autonomic cephalalgia from orbital myositis responsive to high-flow oxygen.
A young woman presented with new-onset, oxygen-responsive headache, periorbital pain and autonomic features. She had associated vertical diplopia on downgaze and subtle ocular misalignment. An initial diagnosis of cluster headache was made. Initial brain MRI was unrevealing, but dedicated MRI of the orbits showed enhancement of orbital muscles. The diplopia and the imaging findings were consistent with orbital myositis.
Orbital myositis mimicking cluster headache is rare, and not previously reported as an oxygen-responsive headache.
眼眶肌炎是一种特发性、非传染性疾病，通常发生在年轻女性中，通常影响一条眼外肌。模仿丛集性头痛的眼眶肌炎是一种罕见的临床实体，这是首例由眼眶肌炎引起的继发性三叉自主神经性头痛的描述，对高流量氧气有反应。
一位年轻女性出现新发、对氧气有反应的头痛、眶周疼痛和自主神经症状。她在向下凝视时有垂直复视，并且有轻微的眼球斜视。最初诊断为丛集性头痛。初始脑部 MRI 无明显异常，但眼眶专用 MRI 显示眶肌增强。复视和影像学表现符合眼眶肌炎。
模仿丛集性头痛的眼眶肌炎很少见，以前也没有报道过对氧气有反应的头痛。
