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Prevalence and preferred medication for vestibular migraine in Menière’s disease: a multicenter retrospective cohort study in Korea 梅尼埃病前庭性偏头痛的发病率和首选药物:韩国一项多中心回顾性队列研究
Pub Date : 2024-06-15 DOI: 10.21790/rvs.2024.005
Dong-Han Lee, Hong Ju Park, Kyu-Sung Kim, Hyun Ji Kim, Jae-Yong Byun, Min-Beom Kim, Minbum Kim, Myung-Whan Suh, Jae-Hyun Seo, Jong Dae Lee, Eun-Ju Jeon, Myung Hoon Yoo, Seok Min Hong, Sung-Kwang Hong, Hyo-Jeong Lee, Jung Woo Lee, Se-Joon Oh, Hyun Ah Kim, Hyung Lee, Eek-Sung; Eeksung Lee, Eunjin Kwon, Seong-Hae Jeong, Jeong-Yoon Choi, C. Kim
Objectives: The aim of this study is to categorize headaches associated with definite Menière’s disease (MD) according to diagnostic criteria, to determine their prevalence, and to investigate the preferred medication across participating centers.Methods: Patients diagnosed with definite MD at 17 university hospitals in otolaryngology or neurology departments in Korea between January 1, 2021 to December 31, 2021 were retrospectively included. Data on the presence of accompanying vestibular migraine (VM), migraine or non-migraine headaches, and clinical information were collected. A survey was conducted to assess preferences for treatment drugs for vertigo and headache control in MD patients with headache.Results: A total of 435 definite MD patients were included, with a mean age of 57.0±14.9 years. Among them, 135 (31.0%) had accompanying headaches, of whom 48 (11.0% of all definite MD patients) could be diagnosed with VM. The prevalence of comorbid VM (definite and probable) was significantly higher in females (41 of 288, 14.2%) than in males (7 of 147, 4.8%) (p<0.05). There was no significant difference in the prevalence of comorbid VM between unilateral and bilateral MD patients (10.8% and 13.6%, respectively) (p > 0.05). Benzodiazepines, antihistamines, and antiemetics were mainly preferred for acute vertigo control, while nonsteroidal anti-inflammatory drugs, acetaminophen, and triptans were preferred for acute headache control, and topiramate, propranolol, and calcium channel blockers were mainly preferred for headache prevention.Conclusions: VM is not uncommon in patients with definite MD in Korea. Further research is needed to understand the differences in headache prevalence and preferred medications across different centers.
研究目的本研究旨在根据诊断标准对与明确梅尼埃病(MD)相关的头痛进行分类,确定其发病率,并调查各参与中心的首选药物:方法:回顾性纳入2021年1月1日至2021年12月31日期间在韩国17所大学医院耳鼻喉科或神经内科确诊为明确梅尼埃病的患者。收集的数据包括是否伴有前庭性偏头痛(VM)、偏头痛或非偏头痛以及临床信息。对患有头痛的 MD 患者进行了一项调查,以评估其对眩晕和头痛控制治疗药物的偏好:共纳入 435 名明确的 MD 患者,平均年龄(57.0±14.9)岁。其中 135 人(31.0%)伴有头痛,其中 48 人(占所有明确 MD 患者的 11.0%)可确诊为 VM。女性(288 人中有 41 人,占 14.2%)合并 VM(明确和可能)的比例明显高于男性(147 人中有 7 人,占 4.8%)(P 0.05)。苯二氮卓类药物、抗组胺药和止吐药主要用于控制急性眩晕,而非甾体抗炎药、对乙酰氨基酚和曲坦类药物主要用于控制急性头痛,托吡酯、普萘洛尔和钙通道阻滞剂主要用于预防头痛:结论:在韩国,VM 在明确的 MD 患者中并不少见。结论:在韩国,VM 在明确的 MD 患者中并不少见,需要进一步研究以了解不同中心的头痛患病率和首选药物的差异。
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引用次数: 0
Aperiodic alternating nystagmus in acute lateral medullary infarction: a video report 急性外侧延髓梗死时的周期性交替眼震:视频报告
Pub Date : 2024-06-15 DOI: 10.21790/rvs.2024.010
Ji-Yun Park
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引用次数: 0
Effect of early high-dose steroid treatment in patients with acute vestibular neuritis: a retrospective case-control study 早期大剂量类固醇治疗对急性前庭神经炎患者的影响:一项回顾性病例对照研究
Pub Date : 2024-06-15 DOI: 10.21790/rvs.2024.007
Jung-Yup Lee, H. Kang, Sang-Hyun Kim, Min-Beom Kim
Objectives: This study is performed to evaluate the effect of early steroid treatment within 24 hours of onset in acute vestibular neuritis (AVN).Methods: We performed a retrospective case-control study with 46 patients with AVN. Video head impulse test paradigm (HIMP) and suppression HIMP were performed, and dizziness handicap index (DHI) was determined at initial; all tests were repeated at 1 month. Patients were divided into two groups depending on whether they were treated with steroids (group S, n=21) or not (group n-S, n=25).Results: There was no significant difference in age, sex, and side between the two groups. In HIMP, group S showed a significantly lower occurrence of overt corrective saccade (CS) (p=0.034) and lower peak velocity of overt CS (p=0.020) than group n-S at 1 month. In addition, the DHI score at 1 month was significantly lower in group S than in group n-S (p=0.040). In correlation analysis between subjective symptom and objective parameters, the DHI score showed a significant correlation with the occurrence of overt CS (p=0.028) and PR score (p=0.006) at 1 month.Conclusions: Early steroid treatment in AVN would be helpful for relieving symptoms and the improvement of vestibular ocular reflex function in the recovery phase.
研究目的本研究旨在评估急性前庭神经炎(AVN)患者在发病 24 小时内接受早期类固醇治疗的效果:我们对 46 例 AVN 患者进行了回顾性病例对照研究。方法:我们对 46 名急性前庭神经炎患者进行了回顾性病例对照研究,对他们进行了视频头冲量试验范式(HIMP)和抑制头冲量试验范式(HIMP),并在首次试验时测定了眩晕障碍指数(DHI);所有试验均在 1 个月后重复进行。根据是否接受类固醇治疗(S 组,n=21)将患者分为两组(n-S 组,n=25):结果:两组患者在年龄、性别和体侧方面无明显差异。在 HIMP 中,S 组在 1 个月时明显低于 n-S 组(P=0.034),明显矫正性囊视(CS)的发生率也明显低于 n-S 组(P=0.020)。此外,1 个月时,S 组的 DHI 评分明显低于 n-S 组(p=0.040)。在主观症状与客观参数的相关性分析中,DHI 评分与 1 个月时明显的 CS 发生率(p=0.028)和 PR 评分(p=0.006)有明显相关性:结论:早期类固醇治疗有助于缓解 AVN 的症状和改善恢复期的前庭眼反射功能。
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引用次数: 0
Serum otolin-1 level is specific to benign paroxysmal positional vertigo 血清otolin-1水平是良性阵发性位置性眩晕的特异性指标
Pub Date : 2024-06-15 DOI: 10.21790/rvs.2024.008
Hoon Kim, Eun Ji Kim, Eunjin Kwon, Seong-Hae Jeong
Objectives: When we see patients with a history of positional vertigo (PV), many patients are diagnosed with benign paroxysmal PV (BPPV) by performing a typical history and nystagmus during a positioning maneuver. Recent studies reported that Otolin-1 can be detected in serum and that its levels significantly increase with age and BPPV. Herein, we tried to study the relationship between serum otolin-1 level and the other clinical aspects in patients with PV.Methods: We measured the serum levels of otolin-1 in 117 BPPV patients (82 females; age range, 43–92 years; mean age±standard deviation [SD], 68.5±10.5 years), referred to as the BPPV group; and nine patients (seven females; age range, 61–79 years; mean age±SD, 66.9±5.9 years) with PV not compatible with BPPV, referred to as another PV group. All the BPPV patients were treated with an appropriate canal repositioning maneuver followed by blood sampling within 1 week. Results: The serum levels of otolin-1 were higher in the BPPV group than in another PV group (mean±SD, 350.1±319.1 pg/mL vs. 183.6±134.1 pg/mL, respectively; p=0.037). However, there were no differences in both laboratory findings (serum vitamin D, C-telopeptide of type collagen, and bone mineral density) and clinical findings (age, sex, vertigo duration, ear disease, ear symptom, migraine, motion sickness, trauma, and previous BPPV) between these two groups. Conclusions: Serum otolin-1 level could help predict the current existence of BPPV in patients with PV. However, further validation studies are needed.
目的:当我们接诊有位置性眩晕(PV)病史的患者时,很多患者都会通过典型病史和定位动作中的眼震被诊断为良性阵发性位置性眩晕(BPPV)。最近的研究报告称,血清中可检测到 Otolin-1,且其水平随年龄和 BPPV 的增加而显著升高。在此,我们试图研究 PV 患者血清中奥托林-1 水平与其他临床方面的关系:我们测量了 117 名 BPPV 患者(82 名女性;年龄范围为 43-92 岁;平均年龄±标准差 [SD],68.5±10.5 岁)(称为 BPPV 组)和 9 名不符合 BPPV 的 PV 患者(7 名女性;年龄范围为 61-79 岁;平均年龄±SD,66.9±5.9 岁)(称为另一 PV 组)的血清耳蜗灵-1 水平。所有 BPPV 患者均接受了适当的耳道复位治疗,并在 1 周内进行了抽血。结果BPPV组血清中otolin-1的水平高于另一PV组(平均值±SD,分别为350.1±319.1 pg/mL vs. 183.6±134.1 pg/mL;P=0.037)。然而,两组患者的实验室检查结果(血清维生素 D、C-elopeptide of type collagen 和骨矿物质密度)和临床检查结果(年龄、性别、眩晕持续时间、耳部疾病、耳部症状、偏头痛、晕车、外伤和既往 BPPV)均无差异。结论血清otolin-1水平有助于预测PV患者目前是否存在BPPV。然而,还需要进一步的验证研究。
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引用次数: 0
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Research in Vestibular Science
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