Differential diagnosis between vertigo of posterior circulation ischemia and migrainous vertigo / 临床耳鼻咽喉头颈外科杂志

ABSTRACT

OBJECTIVE@#To analyze two groups of patients with migrainous vertigo (MV )and vertigo resulting from posterior circulation ischemia (PCIV) and investigate the differential diagnosis between them.@*METHOD@#There were 60 patients with MV and 64 patients with PCIV. Clinical tests include high risk factors of posterior circulation ischemia (PCI), cerebral MRI, ocular motion and high stimulating rate ABR.@*RESULT@#Among 64 patients with PCIV, 29 had abnormal blood pressure and 14 had abnormal blood fat and/or pathoglycemia; 37 had abnormality in cervical vascular ultrasound; 14 suffered from amaurosis or dizziness upon fast getting up. Twenty two had abnormal high stimulating rate ABR and 4 had cerebral lacunar infarction in MRI. As for 60 patients with MV, 45 suffered from motion sickness; 20 were sensitive to motion; 32 had photophobia and (or) phonophobia; 45 had migraine; 16 had abnormal ocular motion function; 3 had abnormal cerebral MRI and 40 had abnormal results in high stimulating rate ABR. The percentage of abnormal high stimulating rate ABR in MV and PCIV were 53% (22/42) and 67% (40/60) respectively.@*CONCLUSION@#The mean age of MV is younger than that of PCIV. Female is more prone to MV than male (2.75 1. 00); the sex difference in PCIV is lesser (1.46 1.00). Motion sickness, motion sensitivity, photophobia and (or) phonophobia are principal differential highlights to MV. The major characteristics of PCIV include abnormal blood pressure, abnormal blood fat, pathoglycemia and arteriosclerosis. Vestibular function tests could not serve as a differential point; Cerebral MRI might be helpful to differential diagnosis. The results of high stimulating rate ABR is not a differential point between PCIV and MV, but it might play a role in differentiating other kinds of vertigo.