Guiloff R J, Fruns M
Department of Neurology, Westminster Hospital, London, UK.
J Neurol Neurosurg Psychiatry. 1988 Aug;51(8):1022-31. doi: 10.1136/jnnp.51.8.1022.
Upper limb pain occurred in close temporal association with attacks of migraine, cluster headache and cluster-migraine in 22 cases. Seven had also lower limb pain. Limb pain was usually ipsilateral to the headache but could alternate sides and behaved like other accepted migraine accompaniments. It was always ipsilateral to the associated paraesthesiae/numbness (9 cases) and weakness (6 cases). The distribution and restricted localisations of limb pain were similar to those of the sensory symptoms and could not be accounted for by primary dysfunction of the peripheral or autonomic nervous systems. A central origin for limb pain is postulated. A temporary dysfunction in the somatosensory cortex, and/or its thalamic connections, during migraine or cluster headache attacks, might mediate such pain in a number of patients.
22例上肢疼痛与偏头痛、丛集性头痛和丛集性偏头痛发作在时间上密切相关。7例还伴有下肢疼痛。肢体疼痛通常与头痛同侧，但可交替出现，表现与其他公认的偏头痛伴随症状相似。它总是与相关的感觉异常/麻木（9例）和无力（6例）同侧。肢体疼痛的分布和局限部位与感觉症状相似，不能用外周或自主神经系统的原发性功能障碍来解释。推测肢体疼痛起源于中枢。偏头痛或丛集性头痛发作期间，体感皮层和/或其丘脑连接的暂时功能障碍可能在一些患者中介导这种疼痛。
