摘要
背景：越來越多的治療眩暈專家認為，良性反覆性眩暈的患者其發作與偏頭痛的體質有某種程度的相關。在本報告中認為病人的眩暈發作與偏頭痛有關是基於3點理由：1）謹慎的刪除許多相關的鑑別診斷，如典型的梅尼爾氏症，自體免疫內耳疾病等，2）病人的眩暈發作對於抗偏頭痛的藥物反應良好，3）追蹤病人至少2年以上。 方法：本科於1995年6月至2000年8月間，對於可能符合上述病況的病人都給予有關頭痛－頭暈臨床症狀的特殊問卷表詳細填寫，共計198份，符合上述3點的共計48人次。 結果：其中女性有42名，男性6名。確定有偏頭痛的病人有30名（女比男=25：5），有頭痛但不符合偏頭痛的診斷標準的有13名，從來不曾頭痛的有5名。上述3組病人具偏頭痛家族史的比例分別是80%，69%，20%。女性第一次發作眩暈的年齡平均為34歲，男性平均為38歲。發作時只有眩暈而完全沒有其他症狀的有7名，有神經耳科學症狀的（例如畏聲、耳鳴、聽力喪失、音頻扭曲、耳塞感等）有32名，而發作時曾表現出局部神經學障礙的有11名，以突發性聾來表現者有3名。此種偏頭痛所引起的頭暈可能是由於中樞前庭神經元的活性失調或是供應前庭的血管不穩定所造成的。 結論：由於偏頭痛的人口很多，因此與之相關的眩暈是鑑別診斷中非常重要的一項；此類病患的眩暈經由投予抗偏頭痛的藥物多半可獲得良好的效果。
並列摘要
BACKGROUND: Many neuro-otologists believe that benign recurrent vertigo (BRV) is strongly associated with migraine. We discuss a number of BRV cases where related differential diagnoses have been excluded, there has been a good response to anti-migrainous drugs, and there has been more than two years of follow-up. METHODS: Between June 1995 and August 2000, subjects at Kaung-Tien General Hospital were given a special “vertigo-and-headache” questionnaire. A total of 198 copies were completed. RESULTS: Forty-eight patients undergoing regular follow-up and medical treatment were included. Thirty patients satisfied the criteria of migraine and became the “definite migraine” group while the other 13 patients that had experienced headache but did not satisfy the criteria for migraine became the “probable migraine” group and the remaining five patients reported no episodes of headache at all. The proportions of patients with a positive family history of migraine in these three groups were 80%, 69% and 20% respectively. During attacks, seven patients reported that they only experienced vertigo, 32 patients described associated neuro-otological symptoms, and the remaining 11 patients described no neurological deficits. CONCLUSIONS: In this study, female patients comprised the majority of BRV sufferers. Patients were younger at the time of their first attack than would be expected for Meniere’s disease, and there was a strong familial influence. After taking anti-migrainous agents, around eighty percent of patients described improvement in vertigo attacks within a month. These findings support the notion that BRV and headaches are indeed closely related.
延伸閱讀
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