PDF(Pubmed)
Abstract：
UNASSIGNED: Vestibular migraine (VM) is a relatively new diagnostic entity with incomplete knowledge regarding pathophysiological mechanisms and therapeutic guidelines. By reporting the effect of manual cervical therapy (MCT) on people with VM, we suggest a possible role for upper cervical afferents in VM treatment and/or pathogenesis. The objective was to describe the change in clinical presentation and self-reported symptoms of VM corresponding to MCT and followed up to six months.
UNASSIGNED: A nonrandomised *ABA design was utilised to consecutively and prospectively evaluate selected patients with diagnosed VM. Symptom characteristics (frequency and intensity) were recorded along with standardised patient-reported outcomes (PROs) to document the response to MCT.
UNASSIGNED: Three patients were recruited who met the diagnostic criteria for VM. All three patients demonstrated improvement in both migraine attack and interictal symptom frequency. These improvements mirrored changes in PROs and were sustained over a six-month follow-up period.
UNASSIGNED: The improvement that coincided with the intervention including MCT was rapid, observable and sustained. This suggests that the upper cervical spine could be a therapeutic target in VM and may have implications for future research into the pathogenesis of VM.
Migraine is a complex disorder with many different factors potentially contributing to a person developing the condition. Whilst many different parts of the brain and body have been implicated as potential causes, the neck is often overlooked. To provide the best possible solution to patients suffering all forms of migraine, including vestibular migraine, a broader discussion must include all potential factors that may contribute to the disease developing, and/or contribute to optimal management. This article provides support for the upper neck to be included in that conversation, and provides the basis for further research to determine the significance of the neck in causing and/or treating this disorder.
UNASSIGNED: A nonrandomised *ABA design was utilised to consecutively and prospectively evaluate selected patients with diagnosed VM. Symptom characteristics (frequency and intensity) were recorded along with standardised patient-reported outcomes (PROs) to document the response to MCT.
UNASSIGNED: Three patients were recruited who met the diagnostic criteria for VM. All three patients demonstrated improvement in both migraine attack and interictal symptom frequency. These improvements mirrored changes in PROs and were sustained over a six-month follow-up period.
UNASSIGNED: The improvement that coincided with the intervention including MCT was rapid, observable and sustained. This suggests that the upper cervical spine could be a therapeutic target in VM and may have implications for future research into the pathogenesis of VM.
Migraine is a complex disorder with many different factors potentially contributing to a person developing the condition. Whilst many different parts of the brain and body have been implicated as potential causes, the neck is often overlooked. To provide the best possible solution to patients suffering all forms of migraine, including vestibular migraine, a broader discussion must include all potential factors that may contribute to the disease developing, and/or contribute to optimal management. This article provides support for the upper neck to be included in that conversation, and provides the basis for further research to determine the significance of the neck in causing and/or treating this disorder.
摘要：
■前庭性偏头痛（VM）是一种相对较新的诊断实体，对病理生理机制和治疗指南的了解不完全。通过报告手动宫颈治疗（MCT）对VM患者的影响，我们建议上宫颈传入神经在VM治疗和/或发病机制中的可能作用。目的是描述与MCT相对应的VM的临床表现和自我报告症状的变化，并随访六个月。
■使用非随机*ABA设计连续和前瞻性地评估诊断为VM的选定患者。记录症状特征（频率和强度）以及标准化的患者报告结果（PRO），以记录对MCT的反应。
■招募了3名符合VM诊断标准的患者。所有三名患者的偏头痛发作和发作间症状频率均得到改善。这些改善反映了PRO的变化，并持续了六个月的随访期。
■与包括MCT在内的干预措施相吻合的改善是迅速的，可观察和持续。这表明上颈椎可能是VM的治疗靶标，并可能对VM发病机理的未来研究产生影响。
偏头痛是一种复杂的疾病，有许多不同的因素可能导致一个人发展的条件。虽然大脑和身体的许多不同部分被认为是潜在的原因，脖子经常被忽视。为所有形式的偏头痛患者提供最佳解决方案，包括前庭偏头痛,更广泛的讨论必须包括所有可能导致疾病发展的潜在因素，和/或有助于优化管理。本文为该对话中包含的上颈部提供了支持，并为进一步研究确定颈部在引起和/或治疗这种疾病中的重要性提供了基础。
■使用非随机*ABA设计连续和前瞻性地评估诊断为VM的选定患者。记录症状特征（频率和强度）以及标准化的患者报告结果（PRO），以记录对MCT的反应。
■招募了3名符合VM诊断标准的患者。所有三名患者的偏头痛发作和发作间症状频率均得到改善。这些改善反映了PRO的变化，并持续了六个月的随访期。
■与包括MCT在内的干预措施相吻合的改善是迅速的，可观察和持续。这表明上颈椎可能是VM的治疗靶标，并可能对VM发病机理的未来研究产生影响。
偏头痛是一种复杂的疾病，有许多不同的因素可能导致一个人发展的条件。虽然大脑和身体的许多不同部分被认为是潜在的原因，脖子经常被忽视。为所有形式的偏头痛患者提供最佳解决方案，包括前庭偏头痛,更广泛的讨论必须包括所有可能导致疾病发展的潜在因素，和/或有助于优化管理。本文为该对话中包含的上颈部提供了支持，并为进一步研究确定颈部在引起和/或治疗这种疾病中的重要性提供了基础。
