Gupta Ankur, Kushwaha Ajeet Kumar, Sen Kanwar, Bajaj Bhupender Kumar
Department of ENT, ABVIMS & DR RML Hospital, New Delhi, India.
Department of Neurology, ABVIMS & DR RML Hospital, New Delhi, India.
Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):420-423. doi: 10.1007/s12070-020-02192-2. Epub 2020 Oct 8.
Benign positional vertigo (BPV) occurs when freely floating otoconia which are normally attached to the utricular macula, enter the posterior semicircular canal and move under the influence of gravity. It is the most common cause of peripheral vertigo. Migraine is a common headache disorder which is characterized by hemicranial, throbbing pain and may be preceded by aura. The relation between vertigo and migraine is intriguing and in day to day practice, often not clear. 100 diagnosed patients of BPV, aged more than 20 years, were evaluated for presence of headache specifically migraine based on International Headache Classification 3rd Edition, beta version. We also compared the success of epley's manoeuvre in patients having BPV & headache as compared to patients with complaints of vertigo alone. Overall seventy-four patients had successful epley's manoeuver and the rest did not show improvement even after four trials. Thirty-four patients reported headache and migraine was diagnosed in only ten patients. 67.6% of patients with headache had successful epley's maneuver however fifty-one of the 66 patients without headache had successful epley's manoeuver. Prevalence of migraine was only 10% in patients with BPV in our population and we observed that presence of headache does not suggest success or failure of epley's manoeuvre.
良性阵发性位置性眩晕(BPV)是指原本附着于椭圆囊斑的自由漂浮耳石进入后半规管并在重力作用下移动时发生的情况。它是周围性眩晕最常见的原因。偏头痛是一种常见的头痛疾病,其特征为半侧头部搏动性疼痛,且可能在发作前出现先兆。眩晕与偏头痛之间的关系很有趣,在日常实践中往往并不明确。根据国际头痛分类第3版beta版,对100例年龄超过20岁的确诊BPV患者进行了头痛(特别是偏头痛)情况的评估。我们还比较了BPV合并头痛患者与仅主诉眩晕患者进行Epley手法复位的成功率。总体而言,74例患者Epley手法复位成功,其余患者即使经过4次尝试也未显示出改善。34例患者报告有头痛,仅10例被诊断为偏头痛。67.6%有头痛的患者Epley手法复位成功,然而66例无头痛的患者中有51例Epley手法复位成功。在我们的研究人群中,BPV患者偏头痛的患病率仅为10%,并且我们观察到头痛的存在并不表明Epley手法复位的成功或失败。