Acıbadem University, School of Medicine, Department of ENT, Istanbul, Turkey.
Acıbadem Health Group, Acıbadem Kozyatagi Hospital, Neurology Department, Istanbul, Turkey.
Acta Otorhinolaryngol Ital. 2022 Jun;42(3):281-286. doi: 10.14639/0392-100X-N1951.
The aim of this study is to evaluate vestibular functions with video head impulse test (VHIT) and to understand the value of VHIT in differential diagnosis in patients with vestibular migraine (VM) during dizziness attack.
Two groups were enrolled in this study. The first consisted of 84 vestibular migraine patients, and second group of 74 healthy subjects. VHIT was applied to patients with VM during vertigo attack and the results were compared with the VHIT values applied to subjects in the control group.
The mean vestibulo-ocular reflex (VOR) in all semicircular canals in the VM group was lower than healthy individuals, but the results were not statistically significant. Refixation saccades were found in 52.3% of VM patients and in 10.2% of healthy individuals.
When patients with VM were evaluated with VHIT during vertiginous attack, VOR gain values were not different from healthy individuals, but the number of catch-up saccades were higher in VM patients, which indicates peripheral vestibular involvement. For differential diagnosis in patients with VM, vestibular tests should be performed during the vertigo attack. When evaluating VHIT results, the presence of refixation saccades should also be evaluated.
本研究旨在评估视频头脉冲试验（VHIT）在眩晕发作时的前庭功能，并了解 VHIT 在前庭性偏头痛（VM）患者中的鉴别诊断价值。
本研究纳入了两组患者。第一组为 84 例前庭性偏头痛患者，第二组为 74 例健康对照者。对 VM 患者在眩晕发作时进行 VHIT，并将结果与对照组的 VHIT 值进行比较。
VM 组各半规管的平均前庭眼反射（VOR）均低于健康对照组，但差异无统计学意义。VM 患者中有 52.3%出现固视性眼震，而健康对照组中仅有 10.2%出现该现象。
当 VM 患者在眩晕发作时接受 VHIT 评估时，VOR 增益值与健康对照组无差异，但 VM 患者的固视性眼震次数更多，这表明外周前庭受累。对于 VM 患者的鉴别诊断，应在眩晕发作时进行前庭功能检查。评估 VHIT 结果时，还应评估固视性眼震的存在。
