Salvesen R, Bogucki A, Wysocka-Bakowska M M, Antonaci F, Fredriksen T A, Sjaastad O
Department of Neurology, Trondheim University Hospital, Norway.
Cephalalgia. 1987 Dec;7(4):273-84. doi: 10.1046/j.1468-2982.1987.0704273.x.
Thirty-two cluster headache patients and healthy controls (n = 16-20 for the various tests) were examined by means of a Whitaker pupillometer during pain-free intervals. Eye drops of the sympathomimetic agents tyramine, hydroxyamphetamine, and phenylephrine were instilled into the conjunctival sacs on separate occasions, and pupillary diameters recorded at standard time intervals. The mydriatic responses of the two pupils were compared. A moderate, but statistically significant, basal relative miosis was found on the pain side in cluster headache. The symptomatic-side pupils were less responsive than their counterparts when stimulated with tyramine and hydroxyamphetamine, the difference being statistically significant for the OH-amphetamine test. With the phenylephrine test, however, the mydriasis on the symptomatic side significantly exceeded that of the contralateral pupil. This pattern of reactions does not quite correspond to those of "ordinary" Horner's syndrome (1st, 2nd, and 3rd neuron lesion). There are, however, gross similarities with the recently reported pattern in central sympathetic neuron dysfunction. In cluster headache there is probably a "Horner-like picture" rather than a proper Horner's syndrome.
32例丛集性头痛患者和健康对照者（各项测试中n = 16 - 20）在无痛间歇期通过惠特克瞳孔计进行检查。在不同时间将拟交感神经药酪胺、羟苯丙胺和去氧肾上腺素滴眼液滴入结膜囊，并在标准时间间隔记录瞳孔直径。比较双侧瞳孔的散瞳反应。发现丛集性头痛患者疼痛侧存在中度但具有统计学意义的基础相对性瞳孔缩小。用酪胺和羟苯丙胺刺激时，症状侧瞳孔的反应性低于对侧，在羟苯丙胺测试中差异具有统计学意义。然而，在去氧肾上腺素测试中，症状侧的散瞳明显超过对侧瞳孔。这种反应模式与“普通”霍纳综合征（第一、第二和第三神经元病变）并不完全相符。然而，与最近报道的中枢交感神经元功能障碍模式有明显相似之处。在丛集性头痛中可能存在“类霍纳征”而非真正的霍纳综合征。
