前庭性偏头痛 前庭性偏头痛的临床特征及诊断标准 Thomas LEMPERT 德国柏林，美欧皇家花园医院，神经内科 在过去的三十年里出现了一种新的前庭综合症，现在称为前庭偏头痛。流行病学研究数据证实前庭性偏头痛的偏头痛症状与前庭症状有着强烈的相关性。针对个体前庭性偏头痛的诊断，是以前庭症状及偏头痛症状出现的时间相关性为基础。国际头痛学会和Bárány 协会共同修订了前庭性偏头痛的诊断标准并于2012 年进行发布。如今，前庭性偏头痛被认为是其中一种最常见的发作性眩晕的病因。前庭性偏头痛的临床表现在前庭症状及发作持续时间上存在异质性。前庭症状包括自发性眩晕、位置性眩晕、头部运动诱发的眩晕、视觉诱发的眩晕，同时伴有如头痛、畏光、畏声、视觉先兆等偏头痛表现。发作持续时间5 分钟~72 小时。与偏头痛相似，没有确切的临床或实验室检查结果能确诊前庭性偏头痛，它的诊断主要根据病史及排除其他疾病。 Vestibular Migraine CLINICAL FEATURES AND DIAGNOSTIC CRITERIA IN VESTIBULAR MIGRAINE Thomas LEMPERT Department of Neurology, Schlosspark-klinik, Berlin, Germany During the last three decades a new vestibular syndrome has emerged that is now termed vestibular migraine. Evidence for vestibular migraine is provided by epidemiologic data demonstrating a strong association between migraine and vestibular symptoms. In individual patients, the diagnosis is based on the temporal association of vestibular and migraine symptoms. Diagnostic criteria for vestibular migraine have been elaborated jointly by the International Headache Society and the Bárány Society and were published in 2012. Today, vestibular migraine is recognised as one of the most common causes of episodic vertigo. The clinical presentation of vestibular migraine is heterogeneous in terms of vestibular symptoms and duration of episodes. Symptoms include spontaneous and positional vertigo but also head motion-induced and visually-induced vertigo accompanied by migraine features such as headache, photo- and phonophobia or visual auras. Attacks may last between 5 minutes and 72 hours. Similar to migraine, there is no clinical or laboratory confirmation for vestibular migraine and the diagnosis relies on the history and the exclusion of other disorders.
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