Sjaastad O, Salvesen R, Antonaci F
Cephalalgia. 1987 Mar;7(1):77-81. doi: 10.1046/j.1468-2982.1987.0701077.x.
We describe a patient with a typical history of cluster headache for more than 18 years. During the first approximately 10 years of his disease, the pain was right-sided, and pupillometric and evaporimetric measurements indicated a sympathetic deficiency on this same side. However, for the next greater than 6 years, his pain was consistently left-sided, although the signs of sympathetic dysfunction still were more marked on the right side. This was also true for the findings obtained during the interictal period and for the heating test performed within an attack. The implications of this interesting case are discussed. The view that two separate lines of symptom production lead to the pain and the autonomic phenomena seems to be supported by this case history. The cluster headache syndrome may also be a bilateral disorder, with only the weight of balance pointing one way or the other. Finally, the autonomic test results of this patient could reflect an autonomic "scar" in the previous headache side.
我们描述了一位患有典型丛集性头痛病史超过18年的患者。在其患病的最初约10年里，疼痛位于右侧，瞳孔测量和泪液分泌测量显示同侧存在交感神经功能不足。然而，在接下来的6年多时间里，他的疼痛一直位于左侧，尽管交感神经功能障碍的体征在右侧仍然更为明显。发作间期获得的检查结果以及发作期间进行的加热试验结果也是如此。本文讨论了这一有趣病例的意义。该病例病史似乎支持这样一种观点，即两条独立的症状产生途径分别导致了疼痛和自主神经现象。丛集性头痛综合征也可能是一种双侧性疾病，只是平衡偏向一侧或另一侧而已。最后，该患者的自主神经测试结果可能反映了先前头痛侧存在的自主神经“瘢痕”。
