Sit-up dizziness and head-shaking dizziness may bediagnostic symptoms of vestibular migraine

[摘要] Background: Vestibular migraine (VM) frequently presents as a diagnostic challenge because objectiveneurological findings consistent with this entity have not been described. Certain patients with VMpresent with dizziness while sitting up or shaking their head, which we have designated as sit-updizziness (SUD) and head-shaking dizziness (HSD) respectively.Objective: To study the prevalence of SUD and HSD in patients with acute VM and to evaluate theirsensitivity and specificity for the diagnosis of acute VM. Methods: We examined 60 patients withVM and compared them to 61 patients with episodic migraine (EM), who were subsequently dividedinto 4 groups (acute-VM, symptom-free-VM, acute-EM, symptom-free-EM). SUD was induced by apositional change from lying to sitting, while HSD was induced by voluntary horizontal head-shaking.The prevalence of SUD and HSD was assessed in the patients during acute and asymptomatic periods.The sensitivity and specificity of SUD and HSD for identification of VM were assessed in an additional85 patients with acute VM and 123 patients with acute EM. Results: The prevalence of SUD andHSD was 72% and 60% respectively in the acute-VM group, which was significantly higher than thesymptom-free-VM, acute-EM and symptom-free-EM groups, and which was not related to sex, age,or symptom duration. SUD and HSD had a sensitivity of 80.0% and 81.2%, and specificity of 75.6%and 78.9%, respectively in diagnosing acute VM. The sensitivity and specificity for either test beingpositive was 91.8% and 71.5%, and 69.4% and 82.9%, when both tests were positive, respectively.Conclusions: SUD and HSD can be used as diagnostic indicators of acute VM that possess highsensitivity and specificity. This study suggests that SUD and HSD are useful diagnostic tests in patientswith new dizziness of unknown cause.

[学科分类] 精神健康和精神病学

[关键词] Dizziness;sit-up dizziness;head-shaking dizziness;vestibular migraine;episodic migraine