青少年前庭性偏头痛的临床特点与疗效研究

Study on the clinical characteristics and efficacy of juvenile vestibular migraine

目的分析青少年前庭性偏头痛的临床特点与疗效。方法选取2021年1月至2022年3月广东省人民医院赣州医院眩晕门诊或住院部收治的58例青少年前庭偏头痛患者作为研究对象,收集患者的病史情况、发病特点,进行视频头脉冲试验、旋转试验、冷热试验等前庭功能检查。统计58例青少年前庭偏头痛患者病史、发病特点、伴随症状及前庭功能检查异常发生率,比较治疗前后视觉模拟评分法(VAS)评分、发作频率评分,并统计患者的临床疗效。结果58例青少年患者中,晕动病和高血压病史占比最多,具有偏头痛家族病史患者较多,具有病史的患者占比70.69%;眩晕发作频率每月1次至每周1次、每周1次至每天1次最常见,眩晕持续时间>5~60min最常见,眩晕类型为自发性眩晕最常见;畏光与畏声、头痛、恶性与呕吐为最常见的伴随症状。58例青少年患者中,视频头脉冲试验、旋转试验与冷热试验异常发生率分别为77.59%、70.69%、55.17%。治疗后,患者VAS评分、发作频率评分均低于治疗前,差异有统计学意义(P<0.05)。治疗后,患者治疗有效率为98.28%。结论青少年前庭性头痛的临床特征复杂多样,大多具有明显的前庭功能异常,临床诊断时需进行全面的评估,通过针对性治疗能够有效改善患者症状,取得良好治疗效果。

Objective To analyze the clinical characteristics and efficacy of juvenile vestibular migraine.Methods 58 adolescent patients with vestibular migraine admitted to the vertigo clinic or inpatient department of Guangdong Provincial People's Hospital Ganzhou Hospital from Janu-ary 2021 to March 2022 were selected as the research subjects,the patient's medical history and disease characteristics were collected,and vestibu-lar function tests such as video head pulse test,rotation test,cold and hot test were performed.The medical history,onset characteristics,accompa-nying symptoms and abnormal incidence of vestibular function examination of 58 adolescent patients with vestibular migraine were counted,the vi-sual analogue scale(VAS)score and seizure frequency score before and after treatment were compared to calculate the clinical efficacy of the pa-tients.Results Among the 58 adolescent patients,the history of motion sickness and hypertension accounted for the most,and there were more pa-tients with a family history of migraine,accounting for 70.69%;the most common frequency of vertigo attack was once a month to once a week,once a week to once a day,the most common duration of vertigo was>5-60 min,the most common type of vertigo was spontaneous vertigo.Photo-phobia and phonophobia,headache,malignancy and vomiting were the most common accompanying symptoms.Among the 58 adolescent patients,the abnormal rates of video head pulse test,rotation test and hot and cold test were 77.59%,70.69%and 55.17%,respectively.After treatment,the VAS score and seizure frequency score of the patients were lower than those before treatment,and the differences were statistically significant(P<0.05).After treatment,the effective rate of treatment was 98.28%.Conclusion The clinical features of vestibular headache in adolescents are com-plex and diverse,and most of them have obvious vestibular dysfunction,comprehensive evaluation is needed in clinical diagnosis,targeted treatment can effectively improve symptoms and achieve good therapeutic effects.