편두통성 현훈의 임상양상 및 신경이과적 소견 (Clinical Manifestations and Neuro-otological Findings of Migrainous Vertigo)

서지정보

· 발행기관 : 대한평형의학회
· 수록지 정보 : Research in Vestibular Science / 11권 / 1호 / 1 ~ 7페이지
· 저자명 : 정현정, 이승한

초록

Background and Objectives: Migrainous vertigo (MV) is one of the recurrent vestibular syndromes and may present episodic vestibular and concurrent migraine symptoms. The clinical manifestations and neuro-otological findings of MV have been delineated over the last couple of decades, however, there are still lots of uncertainties. Materials and Methods: We performed a comprehensive literature search regarding the clinical manifestations and neuro-otological findings of MV compatible with the diagnostic criteria proposed by Neuhuaser. We found the published articles that addressed the clinical and neuro-otological findings and we performed a pooled analysis. Results: Even though the duration of MV attack was variable from seconds to days, the most common durations investigated in this study was minutes (range, 5-60 minutes). During MV attack, most patients had a migraine headache, but instead the other migraine symptoms (i.e., photophobia, phonophobia)could be found. There were positional nystagmus which may not meet a stimulated canal plane and spontaneous nystagmus and, less commonly, gaze-evoked nystagmus.
Regarding bithermal caloric test, unilateral canal paresis could be found in 15-20%of MV patients as well as hyperexcitability in some patients. Oculomotor tests might show impaired pursuits (mainly saccadic pursuit) and saccadic abnormalities such as delayed latency and hypometric saccade. Conclusion: From the result of the pooled analysis, we have found several clinical and neuro-otological findings. However, vital neuro-otological findings which can provide a clue for the diagnosis of MV are still lacking. So the diagnosis of MV should depend on the clinical manifestations and a process of differential diagnosis.

영어초록

Background and Objectives: Migrainous vertigo (MV) is one of the recurrent vestibular syndromes and may present episodic vestibular and concurrent migraine symptoms. The clinical manifestations and neuro-otological findings of MV have been delineated over the last couple of decades, however, there are still lots of uncertainties. Materials and Methods: We performed a comprehensive literature search regarding the clinical manifestations and neuro-otological findings of MV compatible with the diagnostic criteria proposed by Neuhuaser. We found the published articles that addressed the clinical and neuro-otological findings and we performed a pooled analysis. Results: Even though the duration of MV attack was variable from seconds to days, the most common durations investigated in this study was minutes (range, 5-60 minutes). During MV attack, most patients had a migraine headache, but instead the other migraine symptoms (i.e., photophobia, phonophobia)could be found. There were positional nystagmus which may not meet a stimulated canal plane and spontaneous nystagmus and, less commonly, gaze-evoked nystagmus.
Regarding bithermal caloric test, unilateral canal paresis could be found in 15-20%of MV patients as well as hyperexcitability in some patients. Oculomotor tests might show impaired pursuits (mainly saccadic pursuit) and saccadic abnormalities such as delayed latency and hypometric saccade. Conclusion: From the result of the pooled analysis, we have found several clinical and neuro-otological findings. However, vital neuro-otological findings which can provide a clue for the diagnosis of MV are still lacking. So the diagnosis of MV should depend on the clinical manifestations and a process of differential diagnosis.

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