Roosevelt Hospital, Headache Institute, New York, NY 10019, USA.
Headache. 2011 Oct;51(9):1393-7. doi: 10.1111/j.1526-4610.2011.01934.x. Epub 2011 Jun 7.
Migraine and symptoms that may suggest a vestibular disorder (referred to herein broadly as vestibular symptoms-VS) often co-exist. In part due to a lack of standardized diagnostic criteria, this relationship remains unknown to many physicians.
To determine common clinical features that may be associated with "vestibular migraine" (VM).
We retrospectively reviewed charts of patients diagnosed with VM at a headache center. In this group we recorded certain demographic and clinical features related to their disorder, including the most common triggers of the VS and the specific characteristics of the symptoms that suggested VM.
Our sample consisted of 147 patients (68% women, mean age = 45 years, 39% with aura). Migraine onset preceded the onset of VS by a mean of 8 years. A total of 62 patients (42%) had gradual onset of VS, while in 48 (33%) symptoms began suddenly. The most commonly reported symptoms that led to the diagnosis of VM were: unsteadiness (134; 91%), balance disturbance (120; 82%), "light-headedness" (113; 77%), and vertigo (84; 57%). VS and headache occurred concomitantly in 48% of patients. A total of 67 (47%) patients had VS that were chronic from onset, 29 (21%) had episodic symptoms, and in 46 (32%) the VS had evolved from episodic to chronic (with an average duration of 7.04 years required for this evolution to occur).
Vestibular migraine is a heterogeneous condition with varying symptomatology. As with migraine itself, symptomatic expression varies along a spectrum that extends from episodic to chronic. As the histories of many of the patients we evaluated would not meet current International Classification of Headache Disorders criteria, we suggest that new criteria which account for the heterogeneity and natural history of the disorder may be required to adequately diagnose and treat those who suffer from VM.
偏头痛和可能提示前庭障碍（在此广义地称为前庭症状-VS）的症状经常并存。由于缺乏标准化的诊断标准，许多医生对此关系并不了解。
确定可能与“前庭性偏头痛（VM）”相关的常见临床特征。
我们回顾性地审查了头痛中心诊断为 VM 的患者的病历。在该组中，我们记录了与他们的疾病相关的某些人口统计学和临床特征，包括 VS 的最常见诱因以及提示 VM 的症状的具体特征。
我们的样本包括 147 名患者（68%为女性，平均年龄为 45 岁，39%有先兆）。偏头痛发作比 VS 发作早平均 8 年。共有 62 名患者（42%）VS 逐渐发作，而 48 名患者（33%）症状突然发作。导致 VM 诊断的最常见报告症状为：不稳（134 例；91%）、平衡障碍（120 例；82%）、“头晕”（113 例；77%）和眩晕（84 例；57%）。VS 和头痛同时发生在 48%的患者中。共有 67 名患者（47%）从发病开始就有慢性 VS，29 名患者（21%）有发作性症状，而在 46 名患者中（32%）VS 从发作性演变为慢性（平均需要 7.04 年才能发生这种演变）。
前庭性偏头痛是一种具有不同症状表现的异质性疾病。与偏头痛本身一样，症状表现沿着从发作性到慢性的连续谱变化。由于我们评估的许多患者的病史不符合当前的国际头痛疾病分类标准，因此我们建议可能需要制定新的标准来充分诊断和治疗那些患有 VM 的患者，这些标准需要考虑到疾病的异质性和自然病史。
