以單側突發性耳聾為前驅症狀之典型預兆非偏頭痛性頭痛

突發性耳聾好發於40~60歲的成年人，大部分患者會有耳鳴或眩暈，病因尚不明確。－50歲男性，近兩年內，左側耳鳴、腹脹、視覺預兆、頭暈及頭痛等病症已反覆發作共計7次。眼振電圖、兩耳溫差測試及頸性前庭誘發肌性電位檢查呈現可能有中樞性的病變。腦部血管磁振造影呈現前後威利氏環不完整及基底動脈向左偏倚。診斷為典型預兆非偏頭痛性頭痛，然而，每每於發作前總是會先出現左側耳鳴，第5次發作時聽力檢查顯示為左側突發性耳聾，經中耳腔注射類固醇治療後2日後恢復，鑒於反覆發作的特性，應僅為偏頭痛發作前的前驅症狀，局部類固醇治療或許並不需要，建議每日服用苯重氮基鹽oxazolam。爾後第8及9次病症發作時，頭暈及頭痛已明顯減緩。追蹤迄今已逾1年，情況依然穩定。本個案實為罕見，特提出報告。

關鍵字

頭暈；預兆；偏頭痛；突發性耳聾；前驅症狀

並列摘要

Sudden deafness occurs most often in adults between 40 and 60 years old. Most of the victims suffer from tinnitus or vertigo, and the deafness is usually unilaterally. However, it has yet an unknown etiology. A 50-year-old man had been bothered by seven episodes of left tinnitus, abdomen fullness, visual aura, dizziness and headache over the last two years. An electronystagmogram, a caloric test, and measurement of his cervical vestibular evoked myogenic potential suggested a possible central lesion. A magnetic resonance angiogram of the brain revealed (1) anterior and posterior defects of the circle of Willis, and (2) left deviation of the vertebralbasilar artery. He was diagnosed as suffering from typical aura with non-migrainous headache. It was noteworthy that the left tinnitus always recurred before each attack and pure tone audiometry showed that left hearing loss had occurred after the 5th attack. Two days after corticosteroids had been administered via the intra-tympanic route, his hearing had recovered. Due to recurrence, the left sudden deafness was a premonitory symptom, and corticosteroid treatment perhaps should not be recommended. The patient was treated with regular oxazolam and the dizziness and headache were alleviated following the 8th and 9th attacks. The patient’s situation has remained uneventful over a one year follow up. The above is reported as a rare curiosity.

並列關鍵字

dizziness ； aura ； migraine ； sudden deafness ； premonitory symptom

國際替代計量

以單側突發性耳聾為前驅症狀之典型預兆非偏頭痛性頭痛

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