Department of Neurology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea.
Department of Psychology, Hallym University, Chuncheon, South Korea.
Pain Pract. 2019 Jun;19(5):484-490. doi: 10.1111/papr.12767. Epub 2019 Feb 28.
Dizziness is frequently reported in patients with migraine. However, its assessment is often neglected in clinical practice. We investigated the dizziness handicap experienced by patients with migraine and its contributing factors.
A total of 361 migraine outpatients (270 women, 91 men; mean age 39.01 ± 11.2 years) were given the Korean Dizziness Handicap Inventory (KDHI) questionnaire (total score: 100 points; cutoff: 29). The Headache Impact Test, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Pittsburgh Sleep Quality Index were also administered. Clinical data such as age, sex, number of headache attacks per month, pain intensity on the visual analog scale, and average sleep hours were collected to find contributing factors. Comparisons were made between chronic and episodic migraine.
A total of 153 patients were classified as having dizziness handicap (M+DH) and 208 had migraine without dizziness handicap (M-DH). Patients with M+DH experienced more headache attacks per month than patients with M-DH (P = 0.010). The proportion of patients with chronic migraine was larger in the M+DH group (29.4% vs. 17.3%, P = 0.006). Patients with M+DH showed higher scores than patients with M-DH in all the KDHI subscales. Multivariable logistic regression showed headache impact, pain intensity, anxiety, and depression to be significantly associated with dizziness handicap.
The data suggest that patients with migraine, especially those with chronic-type migraine, experience physical, emotional, and functional handicaps due to dizziness. Dizziness handicap is related to headache impact, anxiety, and depression. Targeted management of such factors is required to reduce the severity of subjective discomfort.
偏头痛患者常诉头晕，但在临床实践中往往被忽视。本研究旨在探讨偏头痛患者的头晕障碍及其相关因素。
共纳入 361 例偏头痛患者（270 例女性，91 例男性；平均年龄 39.01±11.2 岁），使用韩国头晕残障量表（KDHI）问卷（总分 100 分，界值 29 分）进行评估。同时还进行了头痛影响测试、广泛性焦虑障碍 7 项量表、患者健康问卷 9 项量表和匹兹堡睡眠质量指数评估。收集患者的年龄、性别、每月头痛发作次数、视觉模拟量表疼痛强度和平均睡眠时间等临床资料，分析头晕障碍的相关因素。比较慢性偏头痛和发作性偏头痛患者间的差异。
共 153 例患者存在头晕障碍（M+DH），208 例患者偏头痛但无头晕障碍（M-DH）。与 M-DH 组相比，M+DH 组患者每月头痛发作次数更多（P=0.010）。M+DH 组慢性偏头痛的比例更大（29.4% vs. 17.3%，P=0.006）。M+DH 组在 KDHI 各维度的评分均高于 M-DH 组。多变量逻辑回归分析显示，头痛影响、疼痛强度、焦虑和抑郁与头晕障碍显著相关。
偏头痛患者，尤其是慢性偏头痛患者，可能因头晕而出现躯体、情绪和功能障碍。头晕障碍与头痛影响、焦虑和抑郁有关。需要针对这些因素进行靶向管理，以减轻患者的主观不适。
