Department of Neurology, Acıbadem University School of Medicine, İçerenköy. Kayışdağı Cad. No: 32. Ataşehir, İstanbul, 34752, Turkey.
Department of Audiology, Acıbadem Maslak Hospital, İstanbul, Turkey.
BMC Neurol. 2024 May 2;24(1):148. doi: 10.1186/s12883-024-03606-2.
During episodes of benign paroxysmal positional vertigo (BPPV), individuals with migraine, compared with individuals without migraine, may experience more severe vestibular symptoms because of their hyperexcitable brain structures, more adverse effects on quality of life, and worse recovery processes from BPPV.
All patients with BPPV were assigned to the migraine group (MG, n = 64) and without migraine group (BPPV w/o MG, n = 64) and completed the Vertigo Symptom Scale (VSS), Vertigo Dizziness Imbalance Symptom Scale (VDI-SS), VDI Health-Related Quality of Life Scale (VDI-HRQoLS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI) at the time of BPPV diagnosis (baseline) and on the one-month follow-up. Headache Impact Test-6 and Migraine Disability Assessment Scale were used for an assessment of headache. Motion sickness was evaluated based on the statement of each patient as present or absent.
Compared with the BPPV w/o MG, the MG had higher VSS scores at baseline [19.5 (10.7) vs. 11.3 (8.5); p < 0.001] and on one-month follow-up [10.9 (9.3) vs. 2.2 (2.7), p < 0.001]; experienced more severe dizziness and imbalance symptoms based on the VDI-SS at baseline (61.9% vs. 77.3%; p < 0.001) and after one month (78.9% vs. 93.7%, p < 0.001); and more significantly impaired quality of life according to the VDI-HRQoLS at baseline (77.4% vs. 91.8%, p < 0.001) and after one month (86.3% vs. 97.6%, p < 0.001). On the one-month follow-up, the subgroups of patients with moderate and severe scores of the BAI were higher in the MG (39.2%, n = 24) than in the BPPV w/o MG (21.8%, n = 14) and the number of patients who had normal scores of the BDI was lower in the MG than in the BPPV w/o MG (67.1% vs. 87.5%, p = 0.038).
Clinicians are advised to inquire about migraine when evaluating patients with BPPV because it may lead to more intricate and severe clinical presentation. Further studies will be elaborated the genuine nature of the causal relationship between migraine and BPPV.
在良性阵发性位置性眩晕 (BPPV) 发作期间，偏头痛患者的前庭症状可能比非偏头痛患者更严重，因为偏头痛患者的大脑结构过度兴奋，对生活质量的负面影响更大，并且从 BPPV 中恢复的过程更差。
所有 BPPV 患者均分为偏头痛组 (MG，n=64) 和非偏头痛组 (BPPV 无偏头痛组，n=64)，并在 BPPV 诊断时 (基线) 和一个月随访时完成眩晕症状量表 (VSS)、眩晕失衡症状量表 (VDI-SS)、VDI 健康相关生活质量量表 (VDI-HRQoLS)、贝克焦虑量表 (BAI) 和贝克抑郁量表 (BDI)。头痛影响测试-6 和偏头痛残疾评估量表用于评估头痛。晕车根据每位患者的陈述评估为存在或不存在。
与 BPPV 无偏头痛组相比，偏头痛组在基线时 VSS 评分更高[19.5(10.7)比 11.3(8.5)；p<0.001]，一个月随访时更高[10.9(9.3)比 2.2(2.7)，p<0.001]；根据 VDI-SS，基线时头晕和失衡症状更严重 (61.9%比 77.3%；p<0.001)，一个月后更严重 (78.9%比 93.7%，p<0.001)；根据 VDI-HRQoLS，基线时生活质量更明显受损 (77.4%比 91.8%；p<0.001)，一个月后更明显受损 (86.3%比 97.6%；p<0.001)。在一个月的随访中，偏头痛组中 BAI 中度和重度评分的亚组患者高于 BPPV 无偏头痛组 (39.2%，n=24)和 BDI 正常评分的患者低于 BPPV 无偏头痛组 (67.1%比 87.5%，p=0.038)。
临床医生在评估 BPPV 患者时应询问偏头痛，因为这可能导致更复杂和严重的临床表现。进一步的研究将详细阐述偏头痛和 BPPV 之间因果关系的真实性质。
