Brantberg Krister, Trees Natalie, Baloh Robert W
Department of Audiology, Karolinska Hospital, Stockholm, Sweden.
Acta Otolaryngol. 2005 Mar;125(3):276-9. doi: 10.1080/00016480510003165.
It is probably not wise to demand a temporal relationship between migraine symptoms and vertigo for the definition of migrainous vertigo. When recurrent vertigo attacks begin at an early age in a patient with normal hearing and migraine, there are few diagnoses other than migraine that need to be considered.
The clinical association between migraine and vestibular symptoms, such as dizziness, motion intolerance and spontaneous attacks of vertigo, is well documented. Recently, investigators have attempted to develop diagnostic criteria for this association. We hypothesized that there are multiple migraine-associated vestibular syndromes and studied a more homogenous subset of them (benign recurrent vertigo).
A structured interview was conducted over the telephone with 40 patients who presented to our neurotology clinic with benign recurrent vertigo and met the International Headache Society criteria for migraine. The structured interview was also conducted with 40 relatives of the patients who reported the same symptoms.
A marked female predominance was found. Most of the patients had vertigo attacks lasting minutes or hours and most were completely free of dizziness between attacks. Imbalance and nausea typically accompanied the vertigo. However, in half of the cases, vertigo occurred without an association with headache.
为偏头痛性眩晕下定义时,要求偏头痛症状与眩晕之间存在时间关系可能并不明智。当在听力正常且患有偏头痛的患者中,复发性眩晕发作在早年开始时,除偏头痛外几乎没有其他诊断需要考虑。
偏头痛与前庭症状(如头晕、运动不耐受和自发性眩晕发作)之间的临床关联已有充分记录。最近,研究人员试图为这种关联制定诊断标准。我们假设存在多种与偏头痛相关的前庭综合征,并对其中一个更同质的子集(良性复发性眩晕)进行了研究。
通过电话对40例因良性复发性眩晕前来我们神经耳科诊所且符合国际头痛协会偏头痛标准的患者进行了结构化访谈。还对40名报告有相同症状的患者亲属进行了结构化访谈。
发现明显以女性为主。大多数患者的眩晕发作持续数分钟或数小时,大多数患者在发作间期完全没有头晕。眩晕通常伴有失衡和恶心。然而,在一半的病例中,眩晕发作与头痛无关。