Vestibular migraine and persistent postural perceptual dizziness.

Scott D Z Eggers, Jeffrey P Staab
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Abstract

Dizziness is a common symptom among patients in primary care, general neurology, and headache clinic practices. Vestibular migraine is conceptualized as a condition of recurrent attacks of vestibular symptoms attributed to migraine. It is now considered the most common cause of spontaneous episodic vertigo. Persistent postural-perceptual dizziness (PPPD) has more recently been defined based on four previous clinical entities as a syndrome of chronic daily dizziness, unsteadiness, or nonspinning vertigo that fluctuates and is exacerbated by postural, motion, or visual factors. Although PPPD is more often precipitated by other conditions causing vertigo, unsteadiness, or dizziness, it is discussed at length in this chapter because vestibular migraine is among the most common triggers for development of PPPD. Pathophysiology of each is incompletely understood, and with lack of biomarkers, the diagnosis of each rests on consensus-derived, symptom-based criteria. Areas of uncertainty exist regarding some overlapping symptoms that may create potential diagnostic confusion between the conditions. This chapter provides a comprehensive review of the current state of vestibular migraine and PPPD, including diagnostic and management guidance for when they occur separately, together, or along with other common comorbidities.

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前庭性偏头痛和持续性姿势感知性头晕。
头晕是初级保健、普通神经内科和头痛诊所患者的常见症状。前庭性偏头痛的概念是由偏头痛引起的前庭症状反复发作。目前,它被认为是自发性发作性眩晕最常见的病因。持续性姿势知觉性眩晕(PPPD)最近根据之前的四个临床实体被定义为一种慢性日常头晕、不稳或非旋转性眩晕综合征,这种眩晕会因姿势、运动或视觉因素而波动和加剧。尽管PPPD更多是由其他导致眩晕、不稳或头晕的疾病诱发的,但由于前庭性偏头痛是PPPD最常见的诱发因素之一,因此本章将对其进行详细讨论。目前对每种疾病的病理生理学尚不完全清楚,由于缺乏生物标志物,对每种疾病的诊断只能依据基于症状的共识标准。在一些症状重叠方面还存在不确定性,这可能会造成这两种疾病在诊断上的混淆。本章全面回顾了前庭性偏头痛和PPPD的现状,包括这两种疾病单独出现、同时出现或与其他常见合并症同时出现时的诊断和管理指南。
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来源期刊
Handbook of clinical neurology
Handbook of clinical neurology Medicine-Neurology (clinical)
CiteScore
4.10
自引率
0.00%
发文量
302
期刊介绍: The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.
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