前庭性偏头痛与几种常见周围性眩晕的鉴别诊断

doi:10.6040/j.issn.1673-3770.1.2019.003

山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (3): 23-26.doi: 10.6040/j.issn.1673-3770.1.2019.003

前庭性偏头痛与几种常见周围性眩晕的鉴别诊断

李晓璐()

南京医科大学第一附属医院江苏省人民医院耳鼻咽喉科，江苏省耳科疾病与听力障碍诊治中心，江苏南京 210029

收稿日期:2019-01-01 修回日期:2019-03-22 出版日期:2019-05-20 发布日期:2019-08-07
通讯作者: 李晓璐 E-mail:lixlnj@qq.com
作者简介:李晓璐，医学博士，南京医科大学第一附属医院（江苏省人民医院）耳鼻咽喉科研究员，硕士研究生导师。主要学术兼职：世界卫生组织预防聋和听力减退合作中心主任助理，国家卫生健康委员会新生儿听力筛查专家组成员，国家新生儿疾病筛查听力筛查专家组成员，中华预防医学会出生缺陷预防与控制专业委员会常务委员，中华医学会耳鼻咽喉头颈外科学分会第九、十届委员会听力学组副组长，中国医疗保健国际交流促进会听力学分会和耳内科学分会委员，中国医师协会耳鼻咽喉科医师分会听力学组委员，江苏省康复医学会听力语言康复专业委员会主任委员。主要研究方向为耳科学和临床听力学，擅长内耳病的诊治。

Differential diagnosis of vestibular migraines and several common types of peripheral vertigo

Xiaolu LI()

Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University

Received:2019-01-01 Revised:2019-03-22 Online:2019-05-20 Published:2019-08-07
Contact: Xiaolu LI E-mail:lixlnj@qq.com

摘要/Abstract

摘要：

前庭性偏头痛（VM）是一种伴有前庭症状的偏头痛，有报道该病占耳鼻咽喉科眩晕门诊16%，被列为所谓“难治性眩晕”的重要病因之一，也是近年来眩晕方面的研究“热点”之一。VM的发病机制目前尚不明确，其临床表现多样，不仅某些表现与耳源性眩晕类似，而且甚至共存于同一患者。加之随着临床前庭功能检查和评估方法的迅速发展，能够对半规管、耳石器以及前庭神经功能进行初步评估。介绍了VM发病机制以及与梅尼埃病、前庭神经炎、良性阵发性位置性眩晕、前庭阵发症等临床常见的耳源性眩晕的鉴别诊断。

关键词: 偏头痛, 前庭, 眩晕, 诊断

Abstract:

Vestibular migraines (VMs) are a type of migraine with vestibular symptoms. Cases of VMs reportedly account for 16% of outpatients with vertigo in otolaryngology departments. They are listed as one of the important causes of so-called refractory dizziness and have been one of the research hotspots in balance disorder in recent years. The pathogenesis of VMs is not yet clear, and their clinical manifestations are diverse. Some manifestations are not only similar to those of otogenic vertigo, but even coexist in the same patient. In addition, with the rapid development of clinical vestibular function examination and evaluation methods, it is possible to perform preliminary evaluations of the semicircular canals, otolith organs, and vestibular nerve function. In this paper, the pathogenesis of VMs and differential diagnosis of four types of clinically common otogenic vertigo, including Meniere′s disease, vestibular neuronitis, benign paroxysmal positional vertigo, and vestibular paroxysmia are discussed, so as to provide clues for the accurate treatment of balance disorder.

Key words: Migraine, Vestibule, Vertigo, Diagnosis

中图分类号:

R764.4

李晓璐. 前庭性偏头痛与几种常见周围性眩晕的鉴别诊断[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 23-26.

Xiaolu LI. Differential diagnosis of vestibular migraines and several common types of peripheral vertigo[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 23-26.

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前庭性偏头痛与几种常见周围性眩晕的鉴别诊断

Differential diagnosis of vestibular migraines and several common types of peripheral vertigo

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