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400016 重庆,重庆医科大学附属第一医院神经内科
[周冀英,E-mail: zheadache@163.com ZHOU Jiying, E-mail: zheadache@163.com
收稿:2020-10-19,
修回:2020-12-10,
纸质出版:2021-04-30
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刘娟, 潘琪, 张芸, 等. 偏头痛患者前庭症状与头痛相关性的临床研究[J]. 第三军医大学学报, 2021,43(8):700-706.
Juan LIU, Qi PAN, Yun ZHANG, et al. Correlation of vestibular symptoms and headache in migraine patients: a clinical study of 424 cases[J]. Journal of Third Military Medical University, 2021, 43(8): 700-706.
刘娟, 潘琪, 张芸, 等. 偏头痛患者前庭症状与头痛相关性的临床研究[J]. 第三军医大学学报, 2021,43(8):700-706. DOI: 10.16016/j.1000-5404.202010117.
Juan LIU, Qi PAN, Yun ZHANG, et al. Correlation of vestibular symptoms and headache in migraine patients: a clinical study of 424 cases[J]. Journal of Third Military Medical University, 2021, 43(8): 700-706. DOI: 10.16016/j.1000-5404.202010117.
目的
2
评估偏头痛患者中前庭症状与头痛的相关性,探讨前庭症状在偏头痛中的诊断应用价值。
方法
2
连续性纳入2019年1-12月首次就诊于我科门诊以头痛为主诉的患者,将诊断符合国际头痛分类第3版(International Classification of Headache Disorders
3rd edition
ICHD-3)的原发性头痛患者分为发作性偏头痛组、慢性偏头痛组、紧张型头痛组,将发作性偏头痛患者分为低频、中频及高频组,以半结构型问卷收集临床症状,前庭症状采用前庭性偏头痛中前庭症状的标准。
结果
2
共纳入424例,发作性偏头
痛组222例,慢性偏头痛组174例,紧张型头痛组28例。前庭症状在偏头痛组及紧张型头痛组中占比分别为25.3%和3.6%,慢性偏头痛组中前庭症状出现的频率(31.0%)高于发作性偏头痛组(20.7%)(
P
=0.019)。将发作性偏头痛患者分成低频、中频及高频组,中频组(头痛频率在2~8 d/月)的人数最多(125/222),且头痛特点及伴随症状最典型。前庭症状与头痛发生的时间相关性中
低频头痛组有68.8%的患者头痛与前庭症状分开发作,高频头痛组和慢性偏头痛组头痛与前庭症状同时发作占比高于低频组(
P
<
0.05)。
结论
2
前庭症状在慢性偏头痛患者中出现频率高,提示前庭症状可能与偏头痛的慢性化相关。
Objective
2
To evaluate the correlation between vestibular symptoms and headache in patients with migraine
and to explore the diagnostic value of vestibular symptoms in migraine.
Methods
2
Consecutive patients who visited our outpatient department of neurology due to a principal complaint of headache during January to December 2019 were recruited in this study. According to the International Classification of Headache Disorders
3rd edition (ICHD-3)
these patients with primary headache were divided into the episodic migraine group
chronic migraine group and tension-type headache group
and those with episodic migraine were assigned into low-
medium-and high-frequency groups. A semi-structured questionnaire was used to collect their information on the clinical symptoms. The vestibular symptoms were identified according to the standard of vestibular symptoms in vestibular migraine.
Results
2
There were 424 patients recruited
including 222 in the episodic migraine group
174 in the chronic migraine group and 28 in the tension-type headache group. Vestibular symptoms accounted for 25.3% and 3.6% in the migraine group and tension-type headache group
respectively. The frequency of vestibular symptoms was higher in the chronic migraine group (31.0%) than the episodic migraine group (20.7%) (
P
=0.019). The medium-frequency group (with a headache frequency of 2~8 d per month) had the largest number of patients (125/222)
with most typical migraine features and accompan
ying symptoms. In the time correlation between vestibular symptoms and headache
68.8% of the patients in the low-frequency group had separate attacks of headache and vestibular symptoms. The simultaneous attack of headache and vestibular symptoms was higher in the high-frequency group and the chronic migraine group than the low-frequency group (
P
<
0.05).
Conclusion
2
Vestibular symptoms occur frequently in patients with chronic migraine
suggesting that vestibular symptoms may be associated with the chronicity of migraine.
NEUHAUSER H K, RADTKE A, VON BREVERN M, et al . Migrainous vertigo: prevalence and impact on quality of life[J ] . Neurology, 2006, 67(6): 1028-1033. DOI: 10.1212/01.wnl.0000237539.09942.06.
PYYKKÖ I, PYYKKÖ N, MANCHAIAH V. Vestibular drop attacks in Ménière's disease and its association with migraine[J]. Eur Arch Oto-Rhino-Laryngol, 2020, 277(7): 1907-1916. DOI: 10.1007/s00405-020-05890-3.
OLESEN J. Problem areas in the International Classification of Headache Disorders, 3rd edition (beta)[J]. Cephalalgia, 2014, 34(14): 1193-1199. DOI: 10.1177/03331024 14534327.
CALHOUN A H, FORD S, PRUITT A P, et al . The point prevalence of dizziness or Vertigo in migraine: and factors that influence presentation[J ] . Headache, 2011, 51(9): 1388-1392. DOI: 10.1111/j.1526-4610.2011.01970.x.
CARVALHO G F, VIANNA-BELL F H, FLORENCIO L L, et al . Presence of vestibular symptoms and related disability in migraine with and without aura and chronic migraine[J ] . Cephalalgia, 2019, 39(1): 29-37. DOI: 10.1177/0333102418769948.
ZHANG Y X, KONG Q T, CHEN J J, et al . International Classification of Headache Disorders 3rd edition beta-based field testing of vestibular migraine in China: Demographic, clinical characteristics, audiometric findings and diagnosis statues[J ] . Cephalalgia, 2016, 36(3): 240-248. DOI: 10.1177/0333102415587704.
ILJAZI A, ASHINA H, LIPTON R B, et al . Dizziness and Vertigo during the prodromal phase and headache phase of migraine: a systematic review and meta-analysis[J ] . Cephalalgia, 2020, 40(10): 1095-1103. DOI: 10.1177/0333102420921855.
CHO S J, KIM B K, KIM B S, et al . Vestibular migraine in multicenter neurology clinics according to the appendix criteria in the third beta edition of the International Classification of Headache Disorders[J ] . Cephalalgia, 2016, 36(5): 454-462. DOI: 10.1177/0333102415597890.
KELMAN L, TANIS D. The relationship between migraine pain and other associated symptoms[J]. Cephalalgia, 2006, 26(5): 548-553. DOI: 10.1111/j.1468-2982.2006.01075.x.
KNIEVEL K, BUCHANAN A S, LOMBARD L, et al . Lasmiditan for the acute treatment of migraine: Subgroup analyses by prior response to triptans[J ] . Cephalalgia, 2020, 40(1): 19-27. DOI: 10.1177/0333102419889350.
SARACCO M G, ALLAIS G, TULLO V, et al . Efficacy of frovatriptan and other triptans in the treatment of acute migraine of normal weight and obese subjects: a review of randomized studies[J ] . Neurol Sci, 2014, 35(1): 115-119. DOI: 10.1007/s10072-014-1752-2.
TEPPER S J, DODICK D W, SCHMIDT P C, et al . Efficacy of ADAM zolmitriptan for the acute treatment of difficult-to-treat migraine headaches[J ] . Headache, 2019, 59(4): 509-517. DOI: 10.1111/head.13482.
NATOLI J L, MANACK A, DEAN B, et al . Global prevalence of chronic migraine: a systematic review[J ] . Cephalalgia, 2010, 30(5): 599-609. DOI: 10.1111/j.1468-2982.2009.01941.x.
BIGAL M E, SERRANO D, BUSE D, et al . Acute migraine medications and evolution from episodic to chronic migraine: a longitudinal population-based study[J ] . Headache, 2008, 48(8): 1157-1168. DOI: 10.1111/j.1526-4610.2008.01217.x.
Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition (beta version)[J]. Cephalalgia, 2013, 33(9): 629-808. DOI: 10.1177/0333102413485658.
CHALMER M A, HANSEN T F, LEBEDEVA E R, et al . Proposed new diagnostic criteria for chronic migraine[J ] . Cephalalgia, 2020, 40(4): 399-406. DOI: 10.1177/0333102419877171.
LIPTON R B, CADY R K, STEWART W F, et al . Diagnostic lessons from the spectrum study[J ] . Neurology, 2002, 58(9 suppl 6): S27-S31. DOI: 10.1212/wnl.58.9_suppl_6.s27.
FURMAN J M, MARCUS D A, BALABAN C D. Vestibular migraine: clinical aspects and pathophysiology[J]. Lancet Neurol, 2013, 12(7): 706-715. DOI: 10.1016/s1474-4422(13)70107-8.
ZHANG Y, ZHANG Y X, TIAN K, et al . Calcitonin gene-related peptide facilitates sensitization of the vestibular nucleus in a rat model of chronic migraine[J ] . J Headache Pain, 2020, 21(1): 1-15. DOI: 10.1186/s10194-020-01145-y.
LEMPERT T, NEUHAUSER H. Migrainous Vertigo[J]. Neurol Clin, 2005, 23(3): 715-730. DOI: 10.1016/j.ncl.2005.01.003.
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