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背景:偏頭痛性眩暈臨床上並不少見,一般建議症狀治療,鮮少有文獻從偏頭痛性眩暈反過來探討偏頭痛,特回顧我們所遇之病例,並提供我們的診療經驗。方法:回溯2008年至2010年間,診斷為偏頭痛性眩暈,並已以磁振造影排除腦腫瘤、腦梗塞或腦出血之患者共計18名(男9,女9),年齡為45.3 ± 12.8歲(平均值 ± 標準差)。回顧他們的頭痛發作狀況、偏頭痛分類(國際頭痛疾病分類第二版)、治療及追蹤。結果:1名診斷為慢性偏頭痛,9名為無預兆偏頭痛,8名為預兆偏頭痛,包括基底型偏頭痛5名、典型預兆偏頭痛性頭痛2名及典型預兆非偏頭痛性頭痛1名。偏頭痛性眩暈可以在偏頭痛發作前出現(7 of 18),伴隨偏頭痛發作(10 of 18),或者在偏頭痛發作後才出現(1 of 18)。爾後追蹤時(7個月~3年)發現,在接受預防性用藥的16名患者中,雖然有4名曾有眩暈發作,並未演變成頭痛發作,其餘12名均無眩暈或頭痛之復發。結論:並非所有的偏頭痛性眩暈患者均具偏頭痛性頭痛,也有不具偏頭痛性頭痛者,而是「非偏頭痛性頭痛」。充分了解偏頭痛性眩暈之偏頭痛,目的在於設法給予預防性用藥,大多數患者可因此而受益。

Parallel abstracts

BACKGROUND: Migrainous vertigo (MV) is clinically a common disease, and symptom control is usually recommended. It is limited in the literature to reversely discuss migraine from the MV sufferers. Herein, we perform a retrospective case-series study and present our therapeutic experience.METHODS: Between 2008 and 2010, 18 patients (nine men and nine women) with the age of 45.3 ± 12.8 (average ± SD) were enrolled. They were diagnosed with MV, and cerebral tumor, infarction or hemorrhage has been ruled out by magnetic resonance imaging. We reviewed (1) the course of headache, (2) the migraine classification (the International Classification of Headache Disorders, 2nd edition), (3) treatment and (4) follow-up.RESULTS: Chronic migraine in one patient; migraine without aura in nine patients, and migraine with aura in eight patients. Among patients suffering from migraine with aura, five had basilar-type migraine, two had typical aura with migraine headache and one had typical aura with non-migraine headache. MV could be presented before headachy attack (7 of 18), during headachy attach (10 of 18) or after headachy attack (1 of 18). Preventive medication was prescribed to 16 patients. Among them, four had vertiginous recurrence without following headache, and the other 12 did not have any vertiginous or headachy recurrence over the following period of seven months to three years.CONCLUSION: Not all MV patients have migraine headache, and some have non-migraine headache. Preventive medication provides benefits for most MV patients if we understand the migraine of MV.