前庭性偏头痛与良性阵发性位置性眩晕的鉴别和共病机制

Differentiation between Vestibular Migraine and Benign Paroxysmal Positional Vertigo and Their Co-Morbid Mechanisms

前庭性偏头痛(vestibular migraine,VM)和良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)是临床最常见的两类发作性眩晕疾病,临床症状有相似性。不典型的VM与BPPV难以鉴别,可以通过临床表现、前庭功能检查、影像检查及生物标志物等多方面进行区分。相似的诱发因素、内耳血管痉挛、炎症反应、遗传因素等可能会导致VM与BPPV共存。因此,需综合分析VM与BPPV的区别和联系,避免误诊、漏诊,从而为患者提供更加精准的诊疗方案。

Vestibular migraine(VM)and benign paroxysmal positional vertigo(BPPV)are the two most common types of episodic vertigo disorders with similar clinical symptoms.Atypical VM is difficult to distinguish from BPPV and the differentiation relies on a combination of clinical manifestations,vestibular function tests,imaging examinations and biomarkers.Similar predisposing factors,inner ear vasospasm,inflammatory responses and genetic factors may lead to the coexistence of VM and BPPV.Therefore,a comprehensive analysis of the differences and connections between VM and BPPV is needed to reduce misdiagnosis and missed diagnoses,thus providing patients with a precisely targeted treatment plan.