Rubin P A, Chen V N, Acquadro M A
Massachusetts Eye and Ear Infirmary, Eye Plastic and Orbit Service, Boston 02114, USA.
Ophthalmic Surg Lasers. 1996 Feb;27(2):143-6.
Acute, noninfectious orbital inflammations often defy a specific diagnosis despite a thorough medical evaluation and are grouped in the nonspecific diagnostic category of idiopathic inflammation of the orbit (pseudotumor). An atypical case of cluster headache presenting with intermittent migratory facial swelling and orbital inflammation, and 3 mm of exophthalmos simulating idiopathic orbital inflammation is presented. Although periobital pain is a frequent finding in patients suffering from cluster headaches, to the authors' knowledge this is the first reported case of orbital inflammation with cluster headache. After unsuccessful treatment directed at potential infectious and inflammatory causes, the patient responded well to methysergide, an established treatment for cluster headaches. A review of the known mechanism for this disorder, peripheral and central nervous system mechanisms of pain, and migratory angioedema reveals overlapping pathophysiology, clinical findings, and associated symptoms.
急性非感染性眼眶炎症尽管经过全面的医学评估，往往仍难以明确诊断，而归入眼眶特发性炎症（假瘤）这一非特异性诊断类别。本文报告了一例不典型的丛集性头痛病例，表现为间歇性游走性面部肿胀和眼眶炎症，伴有3毫米眼球突出，类似特发性眼眶炎症。虽然眶周疼痛在丛集性头痛患者中很常见，但据作者所知，这是首例报告的伴有丛集性头痛的眼眶炎症病例。在针对潜在感染性和炎症性病因的治疗失败后，患者对麦角胺治疗反应良好，麦角胺是治疗丛集性头痛的常用药物。对该疾病已知机制、疼痛的外周和中枢神经系统机制以及游走性血管性水肿的综述显示，它们在病理生理学、临床发现和相关症状方面存在重叠。
