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Clinical Features and Treatment Pattern of Migrainous Vertigo in Korea: A Nationwide Prospective Multicenter Study
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Seong Ki Ahn, Kyusik Kang, Ja Won Koo, Kyu Sung Kim, Beom Gyu Kim, Byung Kun Kim, Ji Soo Kim, Kyoung Ho Park, Shi Nae Park, Eun Ho Park, Hong Ju Park, Jae Yong Byun, Myung Whan Suh, Ki Bum Sung, Sun Young Oh, Chung Ku Rhee, Tae Kyeong Lee, Seong Hae Jeong, Won Ho Chung, Chang Il Cha, Sung Won Chae, Eui Kyung Goh
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Res Vestib Sci. 2009;8(2):122-131.
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 Abstract
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- Background and Objectives It is being increasing recognized that the morbidities of migraine and balance disorders are interrelated. In fact, migrainous vertigo (MV) is one of frequent causes of recurrent vertigo in patients presenting to specialized dizziness clinics. Nevertheless, not many studies have reported clinical manifestations and treatment. Therefore, the aim of study was designed to assess clinical features and treatment patterns by a nationwide multicenter study. Materials and Methods Patients between 9 and 74 years of age who visited 17 Korean tertiary referral centers and 1 clinic from February to March 2009 were investigated using two forms of questionnaires. Results Overall, 318 patients with MV were enrolled. MV was responsible for ~8.45% of visits to the specialized dizziness clinics. One hundred seventy-five of these patients had definite MV and were included in assessing the clinical features. Vertigo characteristics of patients with definite MV were various. Vertigo was regularly as-sociated with headache in 87% of the patients. The duration of vertigo ranged from seconds to days. For the treatment patterns, an acute and prophylactic therapies were carried in most clinics. There were no differences in either acute or prophylactic therapies between department of neurology and otorhinolaryngology. Conclusions The results of this study suggest that MV the clinical features of MV also varies in Korea. In addition, most clinics provide similar patterns of practice in treatment for MV. The syndrome of MV deserves further research activity as it is relatively common and clinically relevant.
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Changes in the Gastrointestinal Motility following Unilateral Labyrinthectomy
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Jae Hee Lee, Gyoung Wan Lee, Suck Jun Choi, Eun Ho Park
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Res Vestib Sci. 2009;8(1):15-22.
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- Background and Objectives The temporal changes and the role of glutamate receptors in the recovery of vestibulogastrointestinal symptoms following unilateral labyrinthectomy (UL) were investigated in this study. Vestibulogastrointestinal symptoms were evaluated in terms of gastric emptying and intestinal transit.
Materials and Methods Expression of the c-Fos protein was observed in the solitary tract nucleus (STN) and rostral ventrolateral medullary nucleus (RVLM). These were measured at 0.5, 2, 6 and 24 h following UL in rats.
Results Gastric emptying and intestinal transit were significantly decreased for 6 h post UL and recovered to control levels within 24 h. Pretreatment of UL animals with MK-801 significantly increased the gastric emptying and intestinal transit. Bilateral labyrinthectomy significantly decreased the gastric emptying and intestinal transit compared to the intact labyrinthine animals but significantly increased when compared to UL animals. The expression of c-Fos protein was significantly increased in STN and RVLM compared to the control animals for 6 h post UL and recovered to control levels within 24 h. The expression was significantly decreased in animals that were pretreated with MK-801.
Conclusion These results suggest that UL decreases the gastrointestinal motility, which recovers to control levels within 24 h post UL. Glutamate plays an important role in the recovery of vestibulogastrointestinal symptoms following UL.
Key Words: Gastric emptying; c-Fos protein; Glutamate; Gastrointestinal Motility; Unilateral labyrinthectomy
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Effect of Ginkgo biloba on Expression of c-Fos Protein in the Vestibular Nuclear Complex following Unilateral Labyrinthectomy in Rats
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Dong Ok Choi, Sun Kyung Kim, Myung Ae Choi, Moon Young Lee, Min Sun Kim, Eun Ho Park, Byung Rim Park
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J Korean Bal Soc. 2003;2(2):163-169.
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- Background
and Objectives: The neuroprotective effect of Ginkgo biloba has been demonstrated in several in vivo and in vitro models. The effect of Ginkgo biloba on vestibular compensation following unilateral labyrinthectomy (UL) was investigated.
Material and Methods: Spontaneous nystagmus and c-Fos protein expression were measured following UL in Sprague-Dawley rats with pretreatment of Ginkgo biloba (50 mg/kg, i.p.).
Results
After pretreatment with Ginkgo biloba (50 mg/kg, i.p.) expression of c-Fos protein in the vestibular nuclear complex and frequency of spontaneous nystagmus were measured till 24 hours after UL. UL produced spontaneous nystagmus with frequency of 124±2.2 beats/min at post-op 2 hrs and 70±3.1 beats/min at post-op 24 hrs. Pretreatment with Ginkgo biloba significantly decreased the frequency of spontaneous nystagmus till post-op 24 hrs compared to control group (p<0.05). UL produced marked expression of c-Fos protein in bilateral medial vestibular nucleus, inferior vestibular nucleus, and superior vestibular nucleus, and the number of expression was significantly higher in contralateral vestibular nuclei to the lesion than ipsilateral vestibular nuclei at post-op 2 hrs (p<0.01). The number of c-Fos protein expression was decreased with time and significantly higher in ipsilateral vestibular nuclei than contralateral ones at post-op 24 hrs (p<0.01). Pretreatment with Ginkgo biloba significantly decreased the number of c-Fos protein expression following UL (p<0.01) and abolished the asymmetry of c-Fos protein expression in bilateral vestibular nuclei at post-op 24 hrs.
Conclusion
These results suggest that Ginkgo biloba may facilitate vestibular compensation following UL through modulation of neurotransmitters and neuroprotective effects.
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Spatio-temporal Changes on c-Fos Protein Expression in the Brain Stem Nuclei following Arsanilate-induced Unilateral Labyrinthectomy in Rats
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Jae Hyo Kim, Chang Ig Choi, Moon Young Lee, Min Sun Kim, Byung Soo Soh, Eun Ho Park, Byung Rim Park
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J Korean Bal Soc. 2003;2(1):86-94.
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- Spatio-temporal changes on c-Fos protein expression were investigated in vestibular compensation following unilateral labyrinthectomy (UL) induced by injection of arsanilate into the middle ear cavity, chemical labyrinthectomy, or surgical labyrinthectomy in medial vestibular nuclei (MVN), prepositus hypoglossal nuclei (PrH), and inferior olivary nuclei (ION) of Sprague-Dawley rats. Number of spontaneous nystagmus in surgical labyrinthectomy group was 28.2±1.2 beats/10 sec at post-op 2 hs and the nystagmus disappeared 76 hs after UL. In chemical labyrinthectomy group, spontaneous nystagmus occurred 6 hs after UL and increased up to maximum at 12 hs and disappeared 96 hs. Head deviation in surgical labyrinthectomy group reached a peak at post-op 2 hs and recovered to control level at 144 hs, but chemical labyrinthectomy produced head deviation 24 hs after UL and increased degree of the deviation over time till 144 hs. Expression of c-Fos protein in surgical labyrinthectomy group at post-op 2 hs was 81±19.4 cells in ipsilateral MVN to the lesion side and 212±60 cells in contralateral MVN, which showed severe asymmetry between bilateral MVN, and decrease of c-Fos protein expression was more in contralateral MVN than in ipsilateral MVN at 6 hs. Chemical labyrinthectomy expressed more c-Fos protein in contralateral MVN 6 hs after UL and in ipsilateral MVN 12 hs after UL, which showed asymmetry of c-Fos protein expression between bilateral MVN. And the expression in ipsilateral MVN of chemical labyrinthectomy group was increased gradually 48 hs after UL and reached a peak at 72 hs. In chemical labyrinthectomy group, expression of c-Fos protein in PrH was increased more in ipsilateral than in contralateral 6 hs after UL and more in contralateral 12 hs after UL, and ION showed more expression of c-Fos protein in contralateral than in ipsilateral 6 hs after UL through 72 hs. These results suggest that the course of vestibular compensation and the temporal expression of c-Fos protein in the brain stem nuclei following UL differed between surgical and chemical labyrinthectomy.
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KBS
