前庭性偏头痛合并良性阵发性位置性眩晕1例

One case of vestibular migraine with benign paroxysmal positional vertigo

良性阵发性位置性眩晕和前庭性偏头痛为2种最常见的眩晕发生原因,二者均表现为发作性眩晕,且可共存在于同一个患者,故给诊断和治疗带来一定的困难。我们报告1例同时存在有良性阵发性位置性眩晕和前庭性偏头痛之少见病例,系一70岁老年女性患者,具有反复性眩晕发作5年的病史,因初诊时其翻滚试验阳性被诊断为良性阵发性位置性眩晕而给予Gufoni法复位治疗,但患者眩晕症状无明显缓解,经进一步检查、会诊,考虑患者同时存在有前庭性偏头痛,经药物治疗其病情得到控制。我们结合文献复习对此类病例的诊疗进行了分析与讨论。

Vestibular migraine is second only to benign paroxysmal positional vertigo as the most common cause of acute episodic vestibular symptoms. Benign paroxysmal positional vertigo （BPPV） and vestibular migraine（VM） are the two most common causes of vertigo. Since the clinical manifestations of the two diseases were paroxysmal vertigo, and one patient may suffer from two kinds of diseases, it brings some difficulties in the diagnosis and treatment. We report a case with VM and BPPV. The patient was a 70-year old woman presented with a 5-year history of repeated attacks of vertigo. The patient was initially diagnosed as having BPPV because the roll test was positive and treated with the Gufoni repositioning maneuver. Since she remained to have episodic vertigo after repositioning treatment, VM as an additional diagnosis was made to this patient and treated with medicine successfully. We review the literature and discuss the diagnosis and management of this condition.