前庭性偏头痛相关问题再探讨

Revisiting issues associated with vestibular migraine

自前庭性偏头痛的诊断标准制定以来,一直是临床关注的热点,目前有被泛化的趋势,一旦误诊、误治或可能直接危及患者生命,这对一直警惕中枢性前庭疾病的耳鼻喉科医生而言,需要再次敲响警钟。急切需要对一些相关问题进行深入探讨,包括:如何对前庭性偏头痛中文术语规范化;如何理解前庭性偏头痛前庭症状的多样性和发作频率特点;如何结合新版梅尼埃病诊断标准,甄别出现中、低频感音神经性耳聋的前庭性偏头痛;如何理解前庭性偏头痛用药特点,尤其是避免含咖啡因药物的滥用;最重要是如何掌握以头痛、头晕为信号的恶性疾病的特点等方面。这些问题在眩晕疾病诊疗过程中常见,不容回避,亟待解决,以达到治疗良性眩晕,提高病人生活质量;识别恶性眩晕,避免患者误诊误治的目标。

Since the establishment of diagnostic criteria for vestibular migraine, it has been a hot spot of clinical concerns.Currently there is a trend of generalization of this disorder and misdiagnosis and mistreatment perhaps directly endangerthe lives of patients. This should once again sound the alarm for otolaryngologist who are concerned over central vestibulardiseases. There is an urgent need for in-depth discussion over some relevant issues including standardization of terminologyof vestibular migraine in Chinese, understanding the diversity and frequency characteristics of vestibular symptomsof vestibular migraine, combining the new diagnosis standards of Meniere's disease to screen for low frequency sensorineuralhearing loss in vestibular migraine, understanding characteristics of medications used for vestibular migraine to avoidabuse of specifically caffeine containing drugs, and, most importantly, mastering the appearance of headache and dizzinessas part of indication of malignant diseases. These problems cannot be avoided and must be managed well in order to improvequality of life of patients with benign vertigo and to avoid misdiagnosis and mistreatment of malignant vertigo.