Inui Takaki, Kimura Fumiharu, Moriyama Kou, Kuriyama Tatsuro, Shirai Takeo, Ayani Yusuke, Inaka Yuko, Yuki Masako, Haginomori Shin-Ichi, Kawata Ryo
Department of Otorhinolaryngology - Head & Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.
Department of Neurology, Osaka Medical and Pharmaceutical University Mishima-minami Hospital, Takatsuki, Osaka, Japan.
Ear Nose Throat J. 2023 Sep 25:1455613231202200. doi: 10.1177/01455613231202200.
This is the first report of vestibular examinations before and after the successful treatment of vestibular migraine (VM), a common cause of recurrent vertigo, with calcitonin gene-related peptide (CGRP) receptor inhibitor. We evaluated a 42-year-old female with VM and concomitant probable Meniere's disease, whose headache and dizziness have improved promptly with the administration of erenumab, a CGRP receptor inhibitor. The sensorineural hearing loss in pure-tone audiometry, dysfunctions shown in vestibular examinations (cervical and ocular vestibular evoked myogenic potentials), and mild endolymphatic hydrops shown in gadolinium-enhanced inner ear magnetic resonance imaging, all in the right ear, revealed no change compared with those observed before treatment. This case suggests that VM may be treated by blocking CGRP in the trigeminal ganglion, which suppresses the effects on the vestibular nucleus; herein, no effects were observed in the inner ear despite the clear amelioration of dizziness.
这是关于用降钙素基因相关肽（CGRP）受体抑制剂成功治疗复发性眩晕的常见病因——前庭性偏头痛（VM）前后进行前庭检查的首份报告。我们评估了一名42岁患有VM并伴有疑似梅尼埃病的女性，其头痛和头晕在使用CGRP受体抑制剂erenumab后迅速改善。纯音听力测定中的感音神经性听力损失、前庭检查（颈性和眼性前庭诱发肌源性电位）显示的功能障碍以及钆增强内耳磁共振成像显示的右耳轻度内淋巴积水，与治疗前相比均无变化。该病例表明，VM可能通过阻断三叉神经节中的CGRP来治疗，这会抑制对前庭核的影响；在此，尽管头晕明显改善，但内耳未观察到影响。
