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前庭性偏头痛:临床与流行病学方面

Vestibular migraine: clinical and epidemiological aspects.

作者信息

Morganti Ligia Oliveira Gonçalves, Salmito Márcio Cavalcante, Duarte Juliana Antoniolli, Bezerra Karina Cavalcanti, Simões Juliana Caminha, Ganança Fernando Freitas

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.

Department of Otorhinolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.

出版信息

Braz J Otorhinolaryngol. 2016 Jul-Aug;82(4):397-402. doi: 10.1016/j.bjorl.2015.06.003. Epub 2015 Oct 29.

Abstract

INTRODUCTION

Vestibular migraine (VM) is one of the most often common diagnoses in neurotology, but only recently has been recognized as a disease.

OBJECTIVE

To analyze the clinical and epidemiological profile of patients with VM.

METHODS

This was a retrospective, observational, and descriptive study, with analysis of patients' records from an outpatient VM clinic.

RESULTS

94.1% of patients were females and 5.9% were males. The mean age was 46.1 years; 65.6% of patients had had headache for a longer period than dizziness. A correlation was detected between VM symptoms and the menstrual period. 61.53% of patients had auditory symptoms, with tinnitus the most common, although tonal audiometry was normal in 68.51%. Vectoelectronystagmography was normal in 67.34%, 10.20% had hyporeflexia, and 22.44% had vestibular hyperreflexia. Electrophysiological assessment showed no abnormalities in most patients. Fasting plasma glucose and glycemic curve were normal in most patients, while the insulin curve was abnormal in 75%. 82% of individuals with MV showed abnormalities on the metabolism of carbohydrates.

CONCLUSION

VM affects predominantly middle-aged women, with migraine headache representing the first symptom, several years before vertigo. Physical, auditory, and vestibular evaluations are usually normal. The most frequent vestibular abnormality was hyperreflexia. Most individuals showed abnormality related to carbohydrate metabolism.

摘要

引言

前庭性偏头痛(VM)是神经耳科学中最常见的诊断之一,但直到最近才被确认为一种疾病。

目的

分析VM患者的临床和流行病学特征。

方法

这是一项回顾性、观察性和描述性研究,分析了一家VM门诊患者的病历。

结果

94.1%的患者为女性,5.9%为男性。平均年龄为46.1岁;65.6%的患者头痛时间比头晕时间长。VM症状与月经期之间存在相关性。61.53%的患者有听觉症状,其中耳鸣最为常见,尽管68.51%的患者纯音听力测定正常。眼震电图正常的患者占67.34%,10.20%的患者有反射减退,22.44%的患者有前庭反射亢进。大多数患者的电生理评估无异常。大多数患者的空腹血糖和血糖曲线正常,而75%的患者胰岛素曲线异常。82%的MV患者碳水化合物代谢存在异常。

结论

VM主要影响中年女性,偏头痛是首发症状,比眩晕早数年出现。体格检查、听觉和前庭评估通常正常。最常见的前庭异常是反射亢进。大多数患者存在与碳水化合物代谢相关的异常。

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