Sørlandet Hospital HF, Norway.
Cephalalgia. 2011 Aug;31(11):1211-9. doi: 10.1177/0333102411409074. Epub 2011 Jul 18.
Vestibular migraine (VM) has gained recognition as a distinct clinical entity in recent years. The pathophysiology is unclear. Vestibular evoked myogenic potential (VEMP) is a validated method to test the vestibulocollic reflex and peripheral vestibular hypersensitivity to noise. The aim of our study was to evaluate the vestibular function and sensitivity in a series of VM patients in comparison to ordinary migraine (M) patient and healthy controls.
Thirty-seven patients diagnosed with VM according to the Neuhauser criteria, 32 migraineurs, and 30 healthy persons underwent VEMP testing (response and sound intensity threshold) and a motion sickness susceptibility questionnaire.
We found absence of unilateral or bilateral VEMP response at 90 dB normal hearing level (nHL) in 44% of the VM patients, in 25% of the migraineurs, as compared to in 3% of the healthy controls (p = 0.001). The sound intensity threshold and latencies were similar in all the groups. Migraineurs (VM > M) reported more motion sickness than healthy controls (p = 0.006).
The results indicate more pathology in the VEMP circuitry in migraineurs than in healthy controls. We did not find support for peripheral vestibular hypersensitivity in terms of lower VEMP threshold among VM patients, but they are more sensitive for motion triggers than other migraineurs.
近年来，前庭性偏头痛（VM）已被确认为一种独特的临床实体。其病理生理学尚不清楚。前庭诱发肌源性电位（VEMP）是一种验证性方法，用于测试前庭-耳蜗反射和对噪声的外周前庭高敏感性。我们的研究目的是评估一系列 VM 患者的前庭功能和敏感性，并与普通偏头痛（M）患者和健康对照组进行比较。
根据 Neuhauser 标准诊断的 37 例 VM 患者、32 例偏头痛患者和 30 名健康者接受了 VEMP 测试（反应和声音强度阈值）和晕动病易感性问卷。
我们发现，44%的 VM 患者、25%的偏头痛患者在 90dB 正常听力水平（nHL）时出现单侧或双侧 VEMP 反应缺失，而健康对照组仅为 3%（p = 0.001）。所有组的声音强度阈值和潜伏期相似。偏头痛患者（VM > M）比健康对照组报告更多的晕车（p = 0.006）。
结果表明，偏头痛患者的 VEMP 电路中存在更多的病理变化，而健康对照组则没有。我们没有发现 VM 患者的 VEMP 阈值较低表明外周前庭高敏感性，但与其他偏头痛患者相比，他们对运动触发更为敏感。
