めまい急性期の状態を観察しえた片頭痛関連性めまいの2症例

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Although many patients with both episodic vertigo and migraine have been reported, we have few opportunities to observe pathological nystagmus during an attack in these patients. We report herein on two cases with migraine associated vertigo (MAV) in which neuro-otological findings could be observed at the acute stage of vertigo. The first patient was a 46-year-old woman, with migraine without aura. She visited our clinic complaining of an episodic dizzy feeling with a migrainous headache and phonophobia. On the first examination, she did not show nystagmus or disequilibrium. Four months later, she had further acute vertigo attacks, during which she showed right beating spontaneous nystagmus lasting for 3 hours. Her vertigo attack and headache are currently well-controlled with lomerizine. The second case was a 47-year-old woman who visited our clinic complaining of vertigo accompanied by a migrainous headache and left tinnitus. On the first examination, there were no remarkable findings except for 35% canal paresis of the left ear on caloric testing. Later, she showed direction fixed spontaneous nystagmus during a vertigo attack lasting for a few days. This patients vertigo attack and headache have also been well-controlled with lomerizine. These cases showed that patients with MAV could have acute asymmetrical disorders of the vestibular system. The lesion site was considered to be in the peripheral vestibular system at least in the second case. However, the actual pathophysiology of MAV remains unclear.
2009-02-01

めまい急性期の状態を観察しえた片頭痛関連性めまいの2症例

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