Sjaastad O, Antonaci F, Fragoso Y D
Department of Neurology, Regionsykehuset i Trondheim, Norway.
Cephalalgia. 1988 Jun;8(2):127-32. doi: 10.1046/j.1468-2982.1988.0802127.x.
A 51-year-old male cluster headache patient had during five bouts in the course of 11 years always had the headache attacks on the left side. Autonomic abnormalities were, however, present on the right side. Pupillometrically, there was thus a Horner-like syndrome on the right (non-symptomatic) side, with miosis and a relatively more marked dilatation of that eye subsequent to topical application of a directly working sympathomimetic agent (phenylephrine) than after an indirectly working one (hydroxyamphetamine), whereas this was not the case on the symptomatic side. The findings on evaporimetry were not as clear-cut as the pupillometric findings; however, even facial sweating was consistent with a pathologic condition on the right (non-symptomatic) side. A primary dichotomy of pain and autonomic signs (that is, not due to change of side of pain localization) thus seems to be present in this case.
一名51岁的丛集性头痛男性患者在11年病程中的5次发作期间，头痛总是发作于左侧。然而，自主神经异常却出现在右侧。通过瞳孔测量发现，右侧（无症状）出现类似霍纳综合征的表现，即瞳孔缩小，且局部应用直接作用的拟交感神经药（去氧肾上腺素）后，该侧眼睛的扩张相对更明显，而应用间接作用的拟交感神经药（羟苯丙胺）后则不然，而有症状的一侧并非如此。蒸发测定的结果不如瞳孔测量结果那么明确；然而，即使是面部出汗也与右侧（无症状）的病理状况相符。因此，该病例似乎存在疼痛和自主神经体征的原发性二分法（即不是由于疼痛定位侧的改变）。
