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The Dizziness or Vertigo of Chronic Tension-type Headache



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Background and purpose: Chronic tension-type headache (CTTH) is clinically uncommon. Some sufferers also have dizziness or vertigo. We reviewed the cases we met in recent three years, and shared our experience.Methods: We collected the patients who were diagnosed with CTTH accompanied with dizziness or vertigo, and all the patients had normal magnetic resonance images between 2008 and 2010. Physical examinations, blood examinations, neuro-otologic studies and total cerebral blood flow measurements were performed. The neuro-otologic studies included pure tone audiometry, electronystagmogram, caloric test and air-conducted vibration cervical vestibular evoked myogenic potential.Results: Six patients were enrolled, including four men and two women. Their age was averaged 57.5 years old. Among them, only one was diagnosed with left posterior semicircular canalolithiasis; two, impairment of superior vestibular pathway; two, impairment of vestibular nucleus in brainstem; and one, bilateral central vestibular dysfunction with possible peripheral vestibular dysfunction. They were treated with combined medication. After the CTTH subsided, patients were not bothered with dizziness or vertigo.Conclusions: Peripheral vestibulopathy is responsible for half of them, and central vestibulopathy for the other half, so anti-vertigo could be deliberatively recommended. As the headache remits, the dizziness or vertigo would remit simultaneously.