ISSN 1612-3352

Editors in Chief

Prof. Dr. Claus F. Claussen, Neurootological Research Institute of the Research Society for Smell, Taste, Hearing and Equilibrium Disorders at Bad Kissingen (4-G-F). Bad Kissingen, Germany.
Dr. med. Julia M. Bergmann,
Dr. med. Guillermo O. Bertora,
Otoneuroophthalmological Neurophysiology,
Buenos Aires, Argentina.

Production Managers

Dr. med. Julia M. Bergmann,
Dr. med. Guillermo O. Bertora,
Otoneuroophthalmological Neurophysiology,
Buenos Aires, Argentina.


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Vestibular migraine

Abstract

Migraine is rather often disorder affecting 5-18% of population. And though there is no vestibular migraine in the International Statistical Classification of Deseases (ICD-10), this pathology is under discussion in the neurootological literature. That is why the item of our study has been the correlation between vestibular dysfunction and migraine. Special attention being paid to the criteria when vestibular dysfunction may trigger migraine attacks.
637 persons with average age of 39,6 ± 12,2 y.o. have been examined with established diagnosis – vestibular dysfunction, most of them being Chornobyl clean-uppers and station stuff.
The anamnesis has been carefully recorded with specific attention to vertigo, dizziness and headache. For standardization of the complaints NOASC questionnaire being used. To make the diagnostics objective clinical tests (Uemura, Fukuda) united into 20-score battery have been used. Instrumental methods: vestibular, auditory, visual, somatosensory evoked potentials, ECG with Takahashi maneuver, ENG have been routinely applied for the vestibular dysfunction documentation.
Headaches are reported in 92,4% patients, in 35% of all the patients being typically migrainous (frontal – 46%, occipital – 37%, parietal – 27%, temporal – 24%, related to neck – 30% and with the hand irradiation – 20%).
Vestibular dysfunction has been reported in all the patients. In the complaints structure long-lasting episodes of dizziness, either provoked or augmented by head movements are dominating. According to NOASC the symptom expression index for dizziness being 4, the highest value in the whole symptoms structure. 20-score battery shown 9,7 (normative up to 5), thus indicating mild and middle degree of the dysfunction. Vestibular evoked potentials have shown the increase of all the peak latencies, especially significant for the N1 98.4±30.8 ms. Nystagmography usually reported directional preponderance with labyrintine asymmetry. ECG shown pulse rate increase after Takahashi maneuver. Treatment of the patients been conducted with Tanakan (EGB 761), Arlevert, Vertigoheel, Natil, – with up to 80% positive efficacy. Preliminary data with Betaserk seem to be also optimistic.
So, vertigo-dizziness complaints, disequilibrium documented with postulography or clinical tests, vestibular evoked potentials might be the criteria for establishment of the diagnosis – vestibular migraine with specific for vestibular disorders therapy.

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