RT Journal Article
SR Electronic
T1 Cluster headache-like attack as an opening symptom of a unilateral infarction of the cervical cord: Persistent anaesthesia and dysaesthesia to cold stimuli
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 397
OP 400
DO 10.1136/jnnp.66.3.397
VO 66
IS 3
A1 de la Sayette, Vincent
A1 Schaeffer, Stéphane
A1 Coskun, Oguzhan
A1 Leproux, François
A1 Defer, Gilles
YR 1999
UL http://jnnp.bmj.com/content/66/3/397.abstract
AB A 54 year old man experienced excruciating left retro-orbital pain with lacrimation and redness of the eye representative of a cluster headache attack. This was followed by left hemiparesis with plegia of the lower limb and left Horner’s syndrome. Five days later the hemiparesis recovered while the patient developed hypoanaesthesia to cold stimuli that evoked painful burning dysaesthesia on the right side below the C4 level. MRI disclosed a discrete infarct in the left lateral aspect of the cord at C2 level concomitant to a left vertebral artery thrombosis. This limited infarct and the clinical symptoms suggest a hypoperfusion in the peripheral arterial system of the left hemicord, supplied both by the anterior and posterior spinal arteries. Cluster headache-like attack and persistent dysaesthesia to cold stimuli are discussed respectively in view of the central sympathetic involvement and partial spinothalamic system dysfunction.