■前庭性偏头痛(VM)是一种新定义的临床疾病。已经报道了VM患者的几种前庭异常。然而,到目前为止,没有使用特定的前庭检查来定义VM。因此,前庭检查的效用是有限的。目前,前庭检查的作用尚未明确。我们推测前庭检查结果可以预测VM的预后。我们调查了前庭检查结果与VM患者临床结局之间的关系。
■这项研究包括25例VM患者。前庭检查,包括视频头脉冲测试(V-HIT),颈和眼前庭诱发肌源性电位(c-VEMP和o-VEMP),姿势描记术,和几份问卷,包括头晕障碍清单(DHI),是在初步评估时进行的。VM和常规药物预防性治疗的生活方式修改,包括洛美利嗪,阿米替林,和丙戊酸,被执行了。治疗4周后,使用临床整体改善量表(CGI-s)评估临床改善情况.CGI-S得分之间的关系,几个临床变量,并评估了几次前庭检查的结果。根据眩晕和头痛的治疗结果,将每位患者进一步分为两个亚组:CGI-S评分从0到2(良好反应[GR])和CGI-S评分>3(不良反应[PR])。
■总的来说,治疗后,大多数患者的头晕和头痛有所改善,CGI-s为2.7±1.3。有12个GR,13个有PR。因此,V-HIT和体位造影均不能预测预后。对于c-VEMP,GRs患者与PR相关的AR明显较小(分别为19.2±12.8和62.5±42.5,[p<0.01])。有五个正常人,六个单边,和14在500hzo-VEMP中双边无反应。CGI-s的正常,单边,双侧无反应分别为1.4±0.5、2.8±1.3和3.1±1.2。正常和双侧无反应o-VEMP组之间有统计学意义的差异(p<0.05)。
■VM患者通过改变生活方式和预防性药物治疗,头痛和眩晕均得到改善。前庭检查,尤其是o-或c-VEMP,有利于预测VM的治疗结果。VM的病理生理学与前庭异常密切相关,特别是耳石相关途径。
UNASSIGNED: Vestibular migraine (VM) is a newly defined clinical condition. Several vestibular abnormalities have been reported in patients with VM. However, to date, no specific vestibular examinations are used to define VM. Therefore, the utility of vestibular examinations is limited. Currently, the role of vestibular examination has not been clearly defined. We speculated that the results of vestibular examinations could predict the prognosis of VM. We investigated the relationship between the vestibular examination results and clinical outcomes in patients with VM.
UNASSIGNED: This study included 25 patients with VM. Vestibular examinations, including the video head impulse test (V-HIT), cervical and ocular vestibular evoked myogenic potential (c-VEMP and o-VEMP), posturography, and several questionnaires, including the Dizziness Handicap Inventory (DHI), were conducted at the initial evaluation. Lifestyle modifications for VM and conventional pharmacological prophylactic treatments, including lomerizine, amitriptyline, and valproic acid, were performed. After 4 weeks of treatment, clinical improvements were evaluated using the Clinical Global Improvement Scale (CGI-s). The relationships among the CGI-S score, several clinical variables, and the results of several vestibular examinations were evaluated. Each patient was further classified into two subgroups according to treatment outcomes concerning vertigo and headache: CGI-S score from 0 to 2 (good response [GR]) and CGI-S score > 3 (poor response [PR]).
UNASSIGNED: Overall, after treatment, most of the patients had improved dizziness and headache, and the CGI-s was 2.7 ± 1.3. There were 12 GRs, and 13 had PRs. Thus, neither V-HIT nor posturography predicted the prognosis. For c-VEMP, patients with GRs had significantly small AR concerning PR (19.2 ± 12.8 and 62.5 ± 42.5, respectively, [p < 0.01]). There were five normal, six unilateral, and 14 bilateral no response in 500hz o-VEMP. CGI-s of normal, unilateral, and bilateral no response was 1.4 ± 0.5, 2.8 ± 1.3, and 3.1 ± 1.2, respectively. There was a statistically significant difference between the normal and bilateral non-response o-VEMP groups (p < 0.05).
UNASSIGNED: Patients with VM had improvements in both headache and vertigo through a combination of lifestyle changes and prophylactic medications. Vestibular examinations, especially o- or c-VEMP, are beneficial for predicting the treatment outcomes of VM. The pathophysiology of VM is closely related to vestibular abnormalities, particularly the otolith-related pathways.