Migraine-associated vertigo

A retrospective analysis was performed on consecutive series of 363 patients presenting with vertigo; 32% had migraine. Of the 224 patients with no pathology other than migraine or vestibular dysfunction, migraineurs had a significantly higher prevalence of normal, central, and combined central and peripheral vestibular dysfunction compared to non-migraineurs. The combination of central and peripheral vestibular signs was a feature of migraine with aura. The results support the hypothesis that migraine-associated vertigo is a diagnostic entity.     

Electronystagmographic investigations in migraine and cluster headache during the pain-free interval

An involvement of vestibulocochlear functions has been assumed to occur in migraine even in headache-free intervals. To obtain further information on this subject, we investigated an unselected group of patients with various forms of migraine (n = 94) and cluster headache (n = 8) during pain-free periods by means of electronystagmography (ENG). The investigation showed a normal ENG in all patients with cluster headache and in 85 (90.4%) patients with migraine. Five patients showed increased occurrence of horizontal deviations, indicating an impairment of vigilance. A pathological ENG was observed in only four patients, of whom one with "basilar migraine" showed a disturbance of central vestibular functions. Based on the employed methods, it is concluded that vestibular dysfunctions, and in particular those of central origin, are not common in cluster headache and in migraine-with the possible exception of basilar artery migraine.     

Migraine-associated vomiting and asystole in a child

A variety of symptoms that accompany migraine in the child and adult are mediated by the autonomic nervous system. Significant effects on cardiac rhythm are uncommon, but can be life threatening. We describe a 3-year-old girl in whom migraine-associated vomiting precipitated cardiac asystole which was effectively treated with a cardiac pacemaker.     

Migraine-associated seizure: a case of reversible MRI abnormalities and persistent nondominant hemisphere syndrome

The complex relationship between migraine and epilepsy is highlighted by the occurrence of a seizure during a migraine attack without aura. This phenomenon, referred to as migralepsy, suggests an inherent overlap in the underlying pathophysiology of these events. We report the case of a patient who had a generalized seizure, persistent nondominant hemisphere syndrome, and reversible magnetic resonance imaging abnormalities during a prolonged migraine attack without aura.     

神经内科眩晕/头晕专病门诊患者的病因分析

[目的]探讨神经内科眩晕/头晕专病门诊患者的常见病因及其构成比.[方法]连续收集2014年1月至2015年6月期间以眩晕/头晕为主诉在本院神经内科眩晕专病门诊就诊的患者,病因诊断依据目前国际公认的标准进行操作,分析眩晕/头晕的各种病因的构成比.[结果]共纳入1615例患者,其中男性630例,女性985例,男女比例为1/1.6;眩晕/头晕常见的前5位的病因依次为良性阵发性位置性眩晕、偏头痛性眩晕、双侧前庭神经病、前庭神经炎和中枢性眩晕,各自的构成比分别为28.3％、10.5％、8.0％、5.8％和5.6％;精神障碍性头晕的占比为5.3％,不明原因者占比达18.7％.[结论]良性阵发性位置性眩晕和偏头痛性眩晕是最为常见的眩晕/头晕性疾病,女性较男性更易患眩晕,精神障碍性头晕占比率较低而病因不明的眩晕/头晕占比相对较高.     

TCD对头晕或眩晕患者脑血管病变的分析

目的分析神经科门诊头晕或眩晕患者颅内外血管狭窄发生频率,以及狭窄血管的分布情况,探讨导致头晕或眩晕的动脉狭窄原因。方法对2001年1月~2001年12月神经科门诊筛选主诉为头晕或眩晕,且无其他神经系统局灶体征者1676例。应用经颅多普勒超声(TCD)检测颅内Willis环及颅外颈部血管。结果(1)202例有脑血管的狭窄,血管狭窄的发生率为202/1676(12.10%)。其中,单纯颈动脉系统血管病变的发生率45.05%,高于单纯椎基底动脉系统32.18%(P<0.01);(2)椎动脉狭窄者占11.88%,其中,单侧椎动脉病变占79.167%,左右无明显差别;3.锁骨下动脉狭窄者占32.673%,其中伴盗血综合征者为28.79%。结论临床上不能仅仅简单的把单纯头晕或眩晕患者诊断为功能性疾病或椎基底动脉供血不足。     

头晕或眩晕患者TCD检测血管狭窄率分析

目的：分析头晕、眩晕患者的颅内外血管狭窄的发生率及其与高血压、糖尿病及年龄的关系。方法：通过ＴＣＤ检测２１５９例以头晕、眩晕症状就诊患者的颅内外血管狭窄率。结果：头晕患者血管狭窄率为１３．４２％,眩晕患者血管狭窄率为１７．３５％,两组间比较有显著差异（ｐ＜０．０５）,且眩晕组椎－基底动脉狭窄率明显高于头晕组（ｐ＜０．０００）,两组患者血流速度减低率分别为９．１６％、６．８５％,无显著差异（ｐ＞０．０５）。两组患者中１０７例颅外血管狭窄,２０８例颅内血管狭窄。前循环血管狭窄１７３例、２８例后循环狭窄。诊断为Ｍｏｙａｍｏｙａ病患者３例,锁骨下动脉盗血综合征患者３３例。高血压患者颅内血管狭窄较常见。而糖尿病患者颈动脉系统及颅外各血管受累多见。年龄因素对颅内外各血管的狭窄及血汉速度减低均有相关性。结论：我们认为眩晕患者椎基底动脉狭窄的发生率明显高于头晕患者。两组患者血流速度减低率以后循环为主。血管狭窄以前循环及颅内血管更常见     

基底动脉的CT表现与眩晕或头晕的关系:151例常规CT与临床表现的对照研究

目的　探讨分析中老年人的头晕或眩晕与其常规头颅CT平扫所示基底动脉表现的关系。方法　收集 815例常规头颅CT平扫的影像 ,分析其中 15 1例 5 0或 5 0岁以上有眩晕或头晕症状患者的基底动脉的CT密度、直径、分叉高度和位置 ,并与非眩晕组对照。结果　中老年眩晕或头晕患者基底动脉的CT值及直径的平均值大于非眩晕组 ,P值分别为0 .0 0 3及 0 .0 3 6;非眩晕组 85 %的患者CT值范围为 2 0～ 44 .6Hu ,而眩晕组大于 44 .6Hu的占 3 0 .5 % ;位置及分叉高度两组没有差异。结论　常规头颅CT平扫基底动脉密度的增高、直径的增宽提示患者可能为血管性眩晕 ,应进一步检查除外基底动脉病变。     

Serotonin-induced plasma extravasation in the murine inner ear: possible mechanism of migraine-associated inner ear dysfunction

Sensitivity to sound and vertigo are often components of migraine. Recent studies suggest that plasma extravasation from intradural blood vessels may contribute to migraine pain. This study documented plasma extravasation in the mouse inner ear after intravenous administration of serotonin (5-HT). Horseradish peroxidase (HRP) was injected intravenously to trace protein extravasation in mice, followed 15 min later by intravenous 5-HT or saline. Forty-five minutes later, mice were euthanized. HRP extravasation was visualized immunohistochemically and quantified densitometrically. Baseline and evoked extravasation in stria vascularis and tectorial membrane were indistinguishable from skin, dura mater and tympanic membrane. Brain parenchyma, Scarpa's ganglion, basal spiral ganglion and modiolus, and the central vestibular nerve segment showed no significant 5-HT-induced extravasation. In contrast, 5-HT produced extravasation in the apical spiral ganglion, modiolus, and intralabyrinthine superior and inferior vestibular nerve. Thus, inner ear plasma extravasation is a potential mechanism for migraine-associated vertigo and sound sensitivity.     

眼震电图诊断椎-基底动脉供血不足性眩晕的意义

目的探讨椎-基底动脉供血不足性眩晕患者眼震电图的改变及其临床意义。方法对40例椎-基底动脉供血不足性眩晕患者行眼震电图(ENG)位置试验检测,观察眼震电图位置性眼震的各头位出现率、出现眼震的位置数及位置性眼震的慢相角速度,并以正常健康人为对照。结果椎-基底动脉供血不足性眩晕组位置性眼震出现率达87.5%,多头位出现眼震,位置性眼震强度7.76±6.05/s,明显高于对照组(P<0.01)。治疗后位置性眼震强度较治疗前明显减弱(P<0.01)出现眼震位置数明显减少。结论眼震电图位置试验对椎-基底动脉供血不足性眩晕的诊断及康复是一种必不可少的检查手段。