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Research in Vestibular Science > Volume 11(1); 2012 > Article
Research in Vestibular Science 2012;11(1): 1-7.
편두통성 현훈의 임상양상 및 신경이과적 소견
, 정현정1,2, 이승한1,3
1전남대학교 의과대학 신경과학교실, 2화순전남대학교병원 신경과, 3전남대학교병원 신경과
Clinical Manifestations and Neuro-otological Findings of Migrainous Vertigo
Hyun Jung Jung, Seung Han Lee
1Department of Neurology, Chonnam National University Medical School, Gwangju, Korea. nrshlee@chonnam.ac.kr
2Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
3Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.
Background and Objectives:   Migrainous vertigo (MV) is one of the recurrent vestibular syndromes and may present episodic vestibular and concurrent migraine symptoms. The clinical manifestations and neuro-otological findings of MV have been delineated over the last couple of decades, however, there are still lots of uncertainties.
Materials and Methods:  
We performed a comprehensive literature search regarding the clinical manifestations and neuro-otological findings of MV compatible with the diagnostic criteria proposed by Neuhuaser. We found the published articles that addressed the clinical and neuro-otological findings and we performed a pooled analysis.
Even though the duration of MV attack was variable from seconds to days, the most common durations investigated in this study was minutes (range, 5-60 minutes). During MV attack, most patients had a migraine headache, but instead the other migraine symptoms (i.e., photophobia, phonophobia) could be found. There were positional nystagmus which may not meet a stimulated canal plane and spontaneous nystagmus and, less commonly, gaze-evoked nystagmus. Regarding bithermal caloric test, unilateral canal paresis could be found in 15-20% of MV patients as well as hyperexcitability in some patients. Oculomotor tests might show impaired pursuits (mainly saccadic pursuit) and saccadic abnormalities such as delayed latency and hypometric saccade.
From the result of the pooled analysis, we have found several clinical and neuro-otological findings. However, vital neuro-otological findings which can provide a clue for the diagnosis of MV are still lacking. So the diagnosis of MV should depend on the clinical manifestations and a process of differential diagnosis.
Keywords: Migraine; Vertigo; Clinical feature; Vestibular function test
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