前庭性偏头痛与可能的前庭性偏头痛之间的临床耳神经学差异

文献信息

中文摘要

背景： 前庭性偏头痛（VM）和可能的前庭性偏头痛（VPM）是眩晕的常见病因。本研究的目的是确定VM和VPM患者中听力损失和耳蜗前庭麻痹的患病率。
方法： 对2024年1月至2025年12月期间就诊、诊断为VM或VPM的成年患者进行的回顾性队列研究。评估了人口统计学资料、偏头痛家族史以及听力测定、视频眼震图（VNG）和VHIT的结果。本研究获得了当地伦理委员会的批准。
结果： 共纳入470例患者：53%为VM，47%为VPM。总体而言，大多数为女性（79%），平均年龄51.1 ± 15.2岁。61%接受了听力测试，40%存在听力损失。大多数为轻至中度，51%为单侧听力损失，6.6%有记录的耳蜗前庭麻痹事件。VM与VPM之间在听力损失或耳蜗前庭麻痹的患病率或程度上均无差异。88%的患者可见VNG异常发现，最常见的是中枢性位置性眼震，56%的患者VHIT异常。VM组的偏头痛家族史更高（64% vs 49%）。
结论： VM和VPM患者均表现出高患病率的听力损失和前庭异常，两组之间在严重程度或临床表现上无显著差异。这些发现支持VM和VPM代表单一病理生理连续谱的概念，偏头痛家族史仍是诊断谱系中最可靠的临床鉴别因素。在听力损失或耳蜗前庭麻痹方面，VM与VPM之间似乎没有显著差异。两组之间的主要差异是偏头痛家族史。

英文摘要

BACKGROUND: Vestibular migraine (VM), and probable vestibular migraine (VPM), are frequent causes of vertigo. The objective of this study was to establish the prevalence of hearing loss and cochleovestibular paresis in patients with VM and PVM.
METHODS: Retrospective cohort study of adult patients seen between 01/2024 and 12/2025, diagnosed with VM or PVM. Demographics, family history of migraine and results of audiometry, videonystagmography (VNG), and VHIT were evaluated. This study was approved by the local ethics committee.
RESULTS: A total of 470 patients we included: 53% had VM, 47% PVM. Overall, most were women (79%), average age 51.1 ± 15.2 years. 61% had a hearing test, and 40% had hearing loss. Most were mild-moderate, 51% had unilateral hearing loss and 6.6% had an event of documented cochleovestibular paresis. There were no differences between prevalence or degree of hearing loss or cochleovestibular paresis between VM and PVM. VNG abnormal findings were seen in 88%, most commonly central positional nystagmus, and 56% had an abnormal VHIT. Family history of migraine was greater in the VM group (64% vs 49%).
CONCLUSION: Both VM and PVM patients show a high prevalence of hearing loss and vestibular abnormalities, with no significant differences in severity or clinical presentation between groups. These findings support the concept that VM and PVM represent a single pathophysiology continuum, The family history of migraine remains the most reliable clinical differentiator in the diagnostic spectrum. There appears to be no significant differences between VM and PVM with regards to hearing loss or cochleovestibular paresis. The main differences between both groups is family history of migraine.