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Chronic Tension-Type Headache with Probable Migrainous Vertigo



Parallel abstracts

Tension-type headache (TTH) is yet of unknown etiology, and might have the similar mechanism as migraine. Both of TTH and migraine may present dizziness or vertigo. A 47-year-old male had past histories of type 2 diabetes mellitus, fatty liver and hyperlipidemia instead of hypertension, heart disease, migraine or psychiatrics. He has been bothered with recurrent dizziness, vertigo and headache for 2 months. Physical examination, audiometry, electronystagmogram and vestibular evoked myogenic potential showed right stronger vestibular function than left, and central vestibulopathy was impressed. Magnetic resonance angiogram revealed defects of anterior and posterior circle of Willis. It is probable that postural change induced transient posterior circulation insufficiency, then influenced the central vestibular nucleus, and led to episodic vertigo. Finally, chronic TTH with dizzy aura and probable migrainous vertigo was diagnosed. The disease subsided 4 months after he has been treated conservatively. In the following 5 months, it was uneventful.