Department of Neurology, The 2nd Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China.
Institute of Neuroscience and the Second Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou, 510260, China.
BMC Neurol. 2020 May 25;20(1):211. doi: 10.1186/s12883-020-01786-1.
Vestibular migraine, a kind of acute vestibular syndrome, leads to both migraines and vertigo symptoms in a single patient. The occurrence of vestibular migraine has shown an obvious increase in female groups based on age. Though it is recognized that migraines may cause ischemic lesions in some brain regions, the relationship between vestibular migraine and cerebral infarction has seldom been reported, especially with no known research reports about vestibular migraine with Wallenberg syndrome. Based on this, the connection of the two diseases needs to be the focus of more research.
The patient, a 35-year-old lady, came to our department with severe vertigo and headaches for approximately two years. She suffered from migraines which attacked about twice yearly for nearly a decade. The diffusive weighted imaging showed a subacute infarction in the right lateral medullar. The clinical characteristics and MRI findings supported the diagnosis of vestibular migraine with Wallenberg syndrome. Along with the normal routine medication for vestibular migraine with Wallenberg syndrome, we also prescribed migraine therapy at the same time. In a 3-month follow-up, the patient had suffered only one vertigo attack and she reported that the migraines were less common and less intense than she was previously experiencing.
Due to the fact that vestibular migraine is one of the risk factors of cerebral ischemia, we need to pay more attention to this phenomenon. The current case suggests that both routine medication on ischemic stroke as well as treatment for migraines should be used concurrently in vestibular migraine with Wallenberg syndrome.
前庭性偏头痛是一种急性前庭综合征,可导致单一患者同时出现偏头痛和眩晕症状。基于年龄,前庭性偏头痛在女性群体中的发生率明显增加。尽管人们已经认识到偏头痛可能导致某些脑区发生缺血性病变,但前庭性偏头痛与脑梗死之间的关系很少被报道,特别是前庭性偏头痛伴延髓外侧综合征的研究更是未见报道。基于此,两种疾病之间的联系需要更多的研究。
患者为 35 岁女性,因严重眩晕和头痛约两年就诊于我科。近十年来,她每年偏头痛发作约两次,近两年来头痛加重。弥散加权成像显示右侧延髓外侧亚急性梗死。临床特征和 MRI 检查结果支持前庭性偏头痛伴延髓外侧综合征的诊断。除了常规治疗前庭性偏头痛伴延髓外侧综合征外,我们还同时给予偏头痛治疗。在 3 个月的随访中,患者仅发生了一次眩晕发作,并且她报告偏头痛发作的频率和严重程度均较之前有所减轻。
由于前庭性偏头痛是脑缺血的危险因素之一,我们需要对此现象给予更多关注。本病例提示,对于前庭性偏头痛伴延髓外侧综合征,除了常规治疗缺血性卒中外,还应同时进行偏头痛治疗。