Neuro-otologic Findings in Acute Migrainous Vertigo

[摘要] Background: Even though migraine has long been associated with vertigo, definition and classification of migrainous vertigo (MV) is only beginning. The lack and scarce epidemiologic evidence for this association from controlled studies adds much challenges in diagnosis and treatment. Objective: To describe the clinical spectrum of acute MV and to determine the possible site of vestibular dysfunction, if present. Methods: Thirty patients with acute MV were examined and compared to migraineurs without lifetime vertigo. MV patients were selected according to Neuhauser criteria for definitive MV. All patients were subjected to full neurological evaluation, radiologic brain studies (MRI and MRA) and full audio-vestibular test battery. Patients with acute MV were followed up after one week. Results: Abnormal findings in the vestibular work up were present in 28 MV patients ’93.3%’ with a characteristic positional nystagmus. Central vestibular dysfunction was described in ten patients (35.7%) while peripheral vestibular involvement was found in 11 patients (39.2%). The findings in seven patients (25%) reflected asymmetry in the vestibular system, yet the exact site of dysfunction could not be determined with certainty. In the symptom free interval, no vestibular findings were detected in all patients except two. Conclusion: Acute MV should be considered in the differential diagnosis of vertigo with positional nystagmus and can present both as a central and a peripheral vestibular disorder. [Egypt J Neurol Psychiat Neurosurg.  2010; 47(4): 569-572]

[学科分类] 精神健康和精神病学