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- Can Nitroglycerin Differentiate Benign Recurrent Vertigo From Vestibular Migraine? A Preliminary Study
- Jong Wook Shin, Seong Hae Jeong, Ji Eun Oh, Ae Young Lee, Jae Moon Kim, Ji Soo Kim
- Res Vestib Sci. 2012;11(1):8-13.
- 2,054 View
- 16 Download
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Abstract
PDF - Background and Objectives: Nitroglycerin (NTG), a donor of nitric oxide, is known to provoke migraine attacks in patients with migraine. However, this effect was not explored in patients with benign recurrent vertigo (BRV). To infer the mechanism of BRV, we evaluated provocative effects of NTG in patients with vestibular migraine (VM) and BRV compared with normal controls. Materials and Methods: Thirteen patients with recurrent vertigo, 8 with VM and 5 with BRV, and 5 healthy controls received intravenous infusion of 0.5 μg/kg/min NTG over 20 minutes. Headache intensity (visual analog scale) and associated symptoms were recorded at baseline and every 10 minutes for an hour. And the subjects were also asked to complete a headache diary every hour for another 12 hours. Results: In contrast to normal controls (2/5, 40%, p=0.035) and the patients with BRV (1/5, 20%, p=0.007), all patients with VM (8/8, 100%) had migraine attacks after NTG injection. However, there was no difference in the proportion of the patients with migraine attacks after NTG injection between normal controls and the patients with BRV. Conclusion: In contrast to the patients with VM, patients with BRV are not sensitive to nitric oxide. These results suggest that the pathophysiology of BRV may be different from that of VM.
- Benign Recurrent Vertigo: Clinical Manifestations And Vestibular Function Test
- Chang Hyo Kim, Kyu Sung Kim, Hoseok Choi, Yun Gun Jung, Seung Chul Lee
- J Korean Bal Soc. 2008;7(1):48-54.
- 2,822 View
- 60 Download
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Abstract
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- Background and Objectives: Benign recurrent vertigo has been defined as recurrent spells of vertigo lasting minutes to hours without cochlear and neurologic signs. The etiology is still unclear, but viral and vasospastic etiology as migraine equivalent has been suggested. We attempt to analyze the symptoms and vestibular function test of Benign recurrent vertigo that has clinically diagnosed. Materials and Methods: We analyzed retrospectively the clinical characteristics and vestibular function test including ocular-motor test, rotation test and computerized dynamic posturography from 100 patients with a Benign recurrent vertigo diagnosis. Results: Eight two percent of the patients were female, mean age was 52 years, and mean duration of prevalence was 47.3 months. In the characteristics of vertigo, 91% of patients have spinning sensation during attack. The vertigo attacks most commonly lasts several hours (57%), and frequency of attack is three to twelve time per year in 47%. A high incidence (40%) of headache was detected, but incidence of other associated symptoms including fluctuating hearing loss (3%), tinnitus (27%), aural fullness (9%) was relatively low. The incidence of spontaneous nystagmus and positional nystagmus was 18% and 10% each. Saccadic undershoot was observed in 21% of patients, but it was not associated with other ocular-motor test abnormalities. In rotation test, low gain, phase lead and asymmetry was observed in 18%, 3% and 9%, respectively. There were no abnormal findings in posturography. Conclusions: Although benign recurrent vertigo did not show any characteristic clinical findings or vestibular function test, it deserves to be considered for differential diagnosis of episodic vertigo.
- Migraine and idiopathic recurrent vertigo
- Hyung Lee, Sung Il Sohn, Yong Won Cho
- J Korean Bal Soc. 2002;1(2):240-244.
- 2,067 View
- 7 Download
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Abstract
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- Background
and Objectives: Chronic recurrent attacks of vertigo, not associated with any auditory or neurological symptoms, are a common reason for referral to our neurotology clinic. Even after an extensive neurotological evaluation, some cases remain undiagnosed. We have performed this study to assess the prevalence of migraine in patients with idiopathic isolated recurrent vertigo as compared with controls, and to identify the clinical features and abnormalities of vestibular testing in patients with isolated recurrent vertigo. Materials and methods: We prospectively evaluated 72 consecutive patients who presented to the clinic with isolated recurrent vertigo of unknown cause. All patients underwent diagnostic evaluation to exclude identifiable causes of isolated recurrent vertigo. We compared the prevalence of migraine, according to the International Headache Society (IHS) criteria, in the isolated recurrent vertigo group, with a sex- and age-matched control group of orthopaedic patients. Results: The prevalence of migraine according to IHS criteria was higher in the isolated recurrent vertigo group (61.1 %) than in the control group (10 %; p<0.01). Only 16.7 % of patients had an abnormal vestibular function test. The most common abnormal finding was a unilateral vestibular weakness to caloric stimulation. Conclusions: Our results suggest that migraine should be considered in the differential diagnosis of isolated recurrent vertigo of unknown cause.
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