Study of the features of systemic dizziness in patients with chronic and recurrent migraine
Research Topic: Vietnamese Medical Research
Migraine and vertigo are the most common nervous system disorders in the population; often both are observed in the same patient Despite numerous epidemiological studies showing a close relationship between migraine and vertigo, there are several contentious issues in relation to migraine as a separate disease. These include the question of terminology and the possibility of dealing with vertigo as the main and often the only manifestation of a migraine attack. The aim of our study was to determine the type of vertigo in patients with chronic migraine (CM) and episodic migraine (EM) and the possible pathophysiological mechanisms of the relationship between them. The study involved 113 patients with an established diagnosis of migraine headaches at Tam Anh Hospital and National Otolaryngology Hospital of Vietnam from October 2018 to December 2019. All patients underwent clinical and neurological examination, videonystagmography, and a video head impulse test. It was found that with an increase in the duration of headache (days), the percentage of patients with both systemic vertigo (SV) and non-systemic vertigo (NSV) increased. Based the neurological examination, it was found that a greater percentage of patients with SV noted an increase in symptoms with a change in head position: 61.5 vs. 29.7%, and had a history of hearing problems: 57.7 vs. 38.5%. Analysis of the remaining indicators of subjective otoneurological symptoms did not reveal significant differences. It was found that SV is more characteristic of patients with CM. A relationship between increased vertigo and a change in head position and a history of hearing loss was also identified. This may indicate a pathology of the structures of the inner ear in such patients. Thus, we can assume a mixed nature of SV, the pathophysiological mechanisms of which probably include central sensitization and peripheral vascular mechanisms.