片頭痛228例の検討

―めまい症例を中心に―

抄録

Among the cases that were treated at the Masaki Jibika Clinic in the past 3 years, 228 that met the diagnostic criteria for migraine were extracted, and the data were examined to determine the association of migraine with vertigo and dizziness, in particular. A retrospective review of the data was conducted to determine the age, gender and main complaint of the patients, presence/absence of aura, presence/absence of vertigo, and presence/absence of headache at the initial visit, and the presence/absence of complications such as Ménière’s disease (MD), benign paroxysmal positional vertigo (BPPV), and tension-type headache. The results showed the 228 cases complained 40 male and 188 female patients, the male:female ratio of 1:4.7 indicating that the majority of the patients were women. The average age was 36.6±14.2 years. Most of the patients were in their 30 s or 40 s, this age band accounting for 46.1% of all the cases. Of the 228 patients, 162 complained of vertigo, and only 27 complained of visual aura. The number of cases in which headache was self-reported without vestibular symptoms at the first visit accounted for 95.5%. On the other hand, the number of cases in which headache was self-reported with vestibular symptoms at the first visit accounted for 59.3%. When the month of the year in which the patients made their initial visits were examined, there were no particular months of the year in which patients without vestibular symptoms initially presented, whereas patients with vestibular symptoms tend to present most often in the month of September and October. Of all the patients, 26 had MD, and of the 26, 9 had vestibular migraine; 60 patients had BPPV, of which 25 had vestibular migraine. Of the 228 patients, 70 had vestibular migraine, 4 had orthostatic dysregulation, and 2 had sudden sensorineural hearing loss. Among the patients with tension-type headache, 10 did not have vestibular symptoms, while 45 had vestibular symptoms, indicating that there were significantly more case with vestibular symptoms among the patients with tension-type headache. Although many facts about migraine and vestibular migraine remain unclear, it is important for otolaryngologists to have a good awareness of these conditions, as a large number of cases present with vertigo. As there were many cases with BPPV in our case series, it is suggested that the relationship between migraine and BPPV be examined in a future study.