Salvesen R, de Souza Carvalho D, Sand T, Sjaastad O
Department of Neurology, Trondheim Regional Hospital, Norway.
Cephalalgia. 1988 Dec;8(4):245-53. doi: 10.1046/j.1468-2982.1988.0804245.x.
Thirty-one patients with cluster headache were examined with regard to their forehead sweating pattern, by means of the Evaporimeter. Sweating was stimulated in two different ways: by body heating and by parenterally administered pilocarpine. The resulting increase in evaporation was frequently measured at different positions on both sides of the forehead, and the possibility of variations in the pattern related to the passage of time was specifically scrutinized. Some typical patterns emerged. The previously reported, marked asymmetries of response (deficient heat-induced sweating and pilocarpine supersensitivity of the symptomatic side) at the medial positions in the forehead were confirmed. However, the asymmetries invariably faded to some extent with the passage of time. Patients with cluster headache show gross similarities with, but also some minor differences from, the sweat pattern of patients with brain stem lesions causing a Horner's syndrome. A subdivision of the material into groups in accordance with the pupillometric pattern after sympathomimetic stimulation made it clear that the cases of definite evaporimetric asymmetries ("typical reactions") belonged to the group with a typical pupillometric pattern. These results suggest that from an "autonomic" point of view, subpopulations may exist within the clinical entity of cluster headache.
采用蒸发计对31例丛集性头痛患者的前额出汗模式进行了检查。通过两种不同方式刺激出汗：身体加热和胃肠外给予毛果芸香碱。在前额两侧的不同位置频繁测量由此产生的蒸发增加情况，并特别仔细检查了出汗模式随时间变化的可能性。出现了一些典型模式。前额内侧位置先前报道的明显反应不对称（症状侧热诱导出汗不足和毛果芸香碱超敏反应）得到了证实。然而，随着时间的推移，这些不对称性在一定程度上总是会逐渐消失。丛集性头痛患者与导致霍纳综合征的脑干病变患者的出汗模式有大致相似之处，但也存在一些细微差异。根据拟交感神经刺激后的瞳孔测量模式将材料分组后发现，明确的蒸发不对称病例（“典型反应”）属于具有典型瞳孔测量模式的组。这些结果表明，从“自主神经”角度来看，丛集性头痛临床实体中可能存在亚群。
