편두통과 관련된 어지러움

Abstract

Background : Migraine is a common disorder whose most readily recognized manifestation is headache. However, many patients with migraine also suffer from episodic dizziness. Infrequently, episodic dizziness may even be the only manifestation of migraine (migraine equivalent). To our knowledge, there have been no reports on the clinical features of migraine related dizziness in Korea. We investigated the clinical features and patterns of quantitative vestibular testing in patients with migraine related dizziness. Methods: We studied 53 patients who had provisional diagnosis of migraine related dizziness. The diagnosis of migraine was made in accordance with the international headache society criteria. Each patient completed a standard dizziness questionnaire. Clinical neurotologic examinations, Brain MRI, pure tone audiogram, and electronystagmography including caloric test were performed on all patients. Results : Twenty-seven patients (50.9%) reported a recurrent episodic vertigo as an usual vestibular symptom and twenty-six patients (49.1%) experienced non-vertigious dizziness such as movement associated disequilibrium, unsteadiness, and lightheadedness. The typical episodes of migraine related dizziness lasted either hours (49.1%) or minutes (32.1%). Thirty-two patients (60.4%), displayed consistent temporal relationship between their dizziness and their headache. Six patients(11.3%) had a unilateral hypoexcitability on caloric testing and six patients (11.3%) had a mild unilateral sensorineural deafness on pure tone audiogram. Conclusions : Migraine related dizziness can be considered as a provisional diagnostic entity in clinical practice and a history of migraine should be sought in patients with idiopathic recurrent dizziness.