Ménière's Disease Associated with Migrainous Vertigo
陳建志(Jiann-Jy Chen)；孫盛義(Sheng-Yih Sun)；陳登郎(Dem-Lion Chen)
無預兆偏頭痛 ； 美尼攸氏病 ； 偏頭痛性眩暈 ； migraine without aura ； Ménière's disease ； migrainous vertigo
|Volume or Term/Year and Month of Publication||
6卷5期（2009 / 10 / 31）
391 - 397
Episodes of vertigo, tinnitus and hearing impairment are not only thought of Ménière's disease (MD), but also migrainous vertigo (MV). The differentiation between MD and MV is really a clinical challenge. A 49-year-old male had suffered from migraine without aura in the past. He had been bothered by episodes of vertigo and right tinnitus without headaches over the last four years. Physical examination showed right beating gaze nystagmus and abnormal tandem gait with tilting to left side. Audiometry showed right increased hearing thresholds in each frequency tested, and there was a right positive recruitment test; however, right speech discrimination score was 100%. A magnetic resonance angiogram showed the absence of bilateral posterior communicating arteries and tortuosity of the vertebral-basilar artery. Migrainous symptoms, such as blurred vision, nausea, vomiting, photophobia, and phonophobia were noted at each attack, and an electronystagmogram and vestibular evoked myogenic potential indicated central impairment after an attack. Accordingly, not only MD, but also MV was diagnosed. The symptoms would subside each time after conservative treatment. The following half year follow-up was uneventful.