El-Badry Mohamed Mohamed, Samy Hesham, Kabel Abdel Mageed, Rafat Fatma Mohamed, Sanyelbhaa Hossam
a Faculty of Medicine, Audio-Vestibular Unit , Minia University , Almenia , Egypt.
b Faculty of Medicine, Department of Otolaryngology , Menoufia University , Shebien Elkoom , Egypt.
Acta Otolaryngol. 2017 Jul;137(7):720-722. doi: 10.1080/00016489.2017.1318220. Epub 2017 Apr 27.
The goal of this study was to identify key diagnostic criteria for positional vertical nystagmus caused by vestibular migraine (VM).
The study group included a case series of 13 subjects with VM (10 females and three males with age 38.6 ± 8.9 years); they were complaining of positional vertigo. They were subjected to thorough audiovestibular examination and treated with cinnarizine or topiramate Results: The entire study group demonstrated positional vertical nystagmus (eight patients had up-beating nystagmus and five patients had down-beating nystagmus). The vertigo and nystagmus were elicited in one or more of the following positions: the right & left Dix-Hallpike, supine with head center, head right, and head left positions. The nystagmus had no latency period. It was persistent, non-fatigable and markedly reduced by visual fixation. Prophylactic therapy of VM (topiramate or cinnarizine) cured the positional vertigo in 92% of the study group. Neither the positional vertigo nor the nystagmus recurred in a 3-6 months follow-up period.
VM can induce characteristic form of vertical positional nystagmus and vertigo, which would be treated by medications used for controlling the VM.
本研究的目的是确定前庭性偏头痛（VM）引起的位置性垂直性眼球震颤的关键诊断标准。
研究组包括13例VM患者的病例系列（10名女性和3名男性，年龄38.6±8.9岁）；他们主诉有位置性眩晕。对他们进行了全面的听前庭检查，并用桂利嗪或托吡酯进行治疗。结果：整个研究组均表现出位置性垂直性眼球震颤（8例患者为上跳性眼球震颤，5例患者为下跳性眼球震颤）。眩晕和眼球震颤在以下一个或多个位置诱发：左右Dix-Hallpike试验、头位居中仰卧位、头向右侧位和头向左侧位。眼球震颤无潜伏期。它持续存在，不易疲劳，视觉注视可使其明显减轻。VM的预防性治疗（托吡酯或桂利嗪）使92%的研究组患者的位置性眩晕得到治愈。在3至6个月的随访期内，位置性眩晕和眼球震颤均未复发。
VM可诱发特征性的垂直位置性眼球震颤和眩晕，可通过用于控制VM的药物进行治疗。
