100例前庭型偏头痛患者临床特征分析

Clinical characteristics of 100 vestibular migraine cases

目的：分析前庭型偏头痛（VM）患者的临床特征,了解听觉与前庭功能受累的情况。方法：以100例肯定或可能诊断为VM的患者为研究对象,常规检查包括纯音测听、前庭双温试验、前庭诱发肌源性电位（VEMP）及视频头脉冲试验（v-HIT）。结果：男女发病比例约为1.00：2.57,发病年龄为19-74岁。93例患者有前庭敏感的表现;42例发病时或既往有偏头痛;34例有耳蜗症状（耳鸣、耳闷或耳聋）;17例劳累、紧张或睡眠差易引起眩晕发作;9例有血压低,7例有高血压;2例眩晕发作与体位变化关系密切,1例有视觉先兆。实验室检查中94例查VEMP,44例VEMP值异常;79例查v-HIT,2例异常（均为出现增益降低）;100例均行纯音测听及前庭双温检查,其中35例纯音测听异常,5例前庭双温检查异常。结论：VM多发于女性,以青中年为主,可伴有耳蜗症状,前庭功能检查（低频及高频）基本正常。

Objective：To analyze the characteristics of vestibular migraine（VM）,in order to understand the auditory and vestibular function.Method：One hundred cases of confirmed or suspected VM patients were observed.Routine examination including pure tone test,vestibular dual temperature test and vestibular evoked myogenic potential（VEMP）and video head impulse test（v-HIT）were conducted.Result：The incidence of male and female was about 1.00∶2.57.The average age of onset was 47 years,of which the youngest was 19 years old,and the oldest was 74 years old.Ninty-three cases of patients presented with vestibular sensitive performance,including photophobia,phonophobia,or motion sensitive.Fourty-two patients had migraine at the onset of the disease.Thirty-four patients had cochlear symptoms,including tinnitus,ear fullness,or epicophosis.In seventeen cases of fatigue,tension or poor sleep can cause vertigo.Nine patients had low blood pressure,7patients presented with hypertension.Two cases of vertigo were closely related to the change of position,and 1case had visual aura.In the experiment,94 patients had undergone VEMP test,with 44 cases of abnormal VEMP value.Seventy-nine patients had been examined v-HIT,of whom 2patients were abnormal（both of which were reduced）.Pure tone audiometry was abnormal in 35 cases.Five cases of patients showed abnormal vestibular double temperature test.Conclusion：Vestibular migraine is more prone to female,with young middle age,and can be accompanied by cochlear symptoms.Vestibular function tests（low frequency and high frequency）are normal.