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Research in Vestibular Science > Accepted Articles
Characteristics of Nystagmus during Attack of Vestibular Migraine
YOON Soyeon1, KIM Mi joo2, KIM Minbum1
Correspondence  KIM Minbum ,Tel: 032-290-3051, Fax: 032-290-3050, Email: minbumkim78@gmail.com
Received: May 29, 2019;  Accepted: June 10, 2019.  Published online: June 10, 2019.
Objective:   The purpose of this study is to investigate characteristics of nystagmus during attacks of VM, and to find a distinct clinical features compared to other migraine and peripheral vestibular disorders.
Method:   This study is a retrospective chart review of 82 patients satisfied with VM criteria, which is formulated by the new Bárány Society. Spontaneous and positional nystagmus provoked by various head positions were examined with video-nystagmography (VNG) in all patients. Bithermal caloric test and cervical vestibular evoked myogenic potential test (cVEMP) were also performed. The direction and peak slow-phase velocity (SPV) of nystagmus, unilateral caloric weakness and interaural difference (IAD) of cVEMP were analyzed. Control groups were lesion side in acute VN for nystagmus results and healthy side in PC-BPPV for caloric and cVEMP results. Chi-square test and Mann-Whitney U test were used for statistical analysis.
Results:   During the acute attack, nystagmus was seen in 71.9% (59/82) of patients. Horizontal nystagmus was the predominant type. Peak SPV in VM patients was much slower than in the control group (2.37±1.73 deg/sec vs. 17.05±12.69 deg/sec, p<0.0001). There was no significant difference on the result of both caloric and cVEMP test, compared to those of control groups.
Conclusion:   Nystagmus with horizontal directions and low SPV was dominant form in the attack of VM. Close observation of nystagmus can be helpful to make a correct diagnosis and to understand the pathomechanism of vertigo in VM.
Keywords: vestibular migraine; ictal phase; nystagmus
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