Abstract：
BACKGROUND: Trigeminal autonomic cephalalgias and complex regional pain syndrome are rare conditions, and their co-occurrence has not been reported previously.Clinical findings: In two patients, ipsilateral trigeminal autonomic cephalalgias developed after the onset of upper limb complex regional pain syndrome. Hyperalgesia to thermal and mechanical stimuli extended beyond the affected limb to encompass the ipsilateral forehead, and was accompanied by ipsilateral hyperacusis and photophobia. In addition, examination of the painful limb and bright light appeared to aggravate symptoms of trigeminal autonomic cephalalgias. Detailed examination of the association between facial and upper limb pain indicated that both sources of pain cycled together. Furthermore, in one case, stellate ganglion blockade inhibited pain for an extended period not only in the affected limb but also the face.
CONCLUSIONS: These findings suggest some overlap in the pathophysiology of complex regional pain syndrome and trigeminal autonomic cephalalgias. Specifically, central sensitization and/or disruption of inhibitory pain modulation on the affected side of the body in complex regional pain syndrome might trigger ipsilateral cranial symptoms and increase vulnerability to trigeminal autonomic cephalalgias.
CONCLUSIONS: These findings suggest some overlap in the pathophysiology of complex regional pain syndrome and trigeminal autonomic cephalalgias. Specifically, central sensitization and/or disruption of inhibitory pain modulation on the affected side of the body in complex regional pain syndrome might trigger ipsilateral cranial symptoms and increase vulnerability to trigeminal autonomic cephalalgias.
摘要：
背景：三叉神经自主性头痛和复杂区域疼痛综合征是罕见的疾病，以前没有报道过它们的共现。临床发现：在两名患者中，上肢复杂区域疼痛综合征发作后发生同侧三叉神经自主性头痛。对热和机械刺激的痛觉过敏延伸到患肢之外，涵盖同侧前额，并伴有同侧运动过度和畏光。此外,检查疼痛的肢体和明亮的光线似乎加重了三叉神经自主性头痛的症状。对面部和上肢疼痛之间关联的详细检查表明，两种疼痛来源一起循环。此外，在一个案例中,星状神经节阻滞不仅可以长时间抑制患肢的疼痛，而且可以抑制面部的疼痛。
结论：这些发现提示复杂区域疼痛综合征和三叉神经自主性头痛的病理生理学存在一些重叠。具体来说,在复杂区域疼痛综合征中,身体受影响一侧的中枢致敏和/或抑制性疼痛调节的破坏可能引发同侧颅骨症状,并增加三叉神经自主性头痛的易感性.
结论：这些发现提示复杂区域疼痛综合征和三叉神经自主性头痛的病理生理学存在一些重叠。具体来说,在复杂区域疼痛综合征中,身体受影响一侧的中枢致敏和/或抑制性疼痛调节的破坏可能引发同侧颅骨症状,并增加三叉神经自主性头痛的易感性.
