前庭性偏头痛57例误诊临床剖析OACSTPCD

Objective To analyze the clinical features and causes of misdiagnosis of vestibular migraine (VM) in order to improve the diagnosis rate. Methods Clinical data of 57 patients with VM misdiagnosed as other diseases who were admitted to and treated in Neurology Department of our hospital from September 2016 to January 2018 were retrospectively analyzed. Results All 57 cases were initially diagnosed and misdiagnosed in other hospitals, and the duration of misdiagnosis was 10-70 d, with an average of 25.75 d. Of all patients, 36 cases were misdiagnosed as benign paroxysmal positioning vertigo, 13 cases as meniere disease, and 8 cases as posterior circulation ischemia. All the 57 patients presented with moderate to severe vestibular symptoms for 5 to 12 times, and all of them had aggravated headache symptoms after daily activities. After completion of relevant examinations combined with clinical data, all patients were diagnosed with VM.All patients received oral flunarizine hydrochloride capsules daily for 1 month and required to live and rest regularly for 1 month. In 44 patients, the episodes of vertigo were significantly reduced after treatment, and the number of occurrences was significantly reduced. Six cases of vertigo disappeared, 5 cases had no significant improvement in symptoms and 2 cases were lost to follow-up. The patients were followed up for 3 months.Of them, 34 cases had no recurrence of symptoms. Eleven cases had one mild migraine episode, the duration of which did not exceed 1 h, and there was no vestibular symptom.Three cases presented with one episode of migraine and vestibular symptoms for ＜24 h. There was no significant improvement in 1 case and 8 cases were lost to follow-up. Conclusion The clinical manifestations of VM are non-specific and vary greatly among individuals. Clinicians should strengthen the awareness and vigilance of this disease to avoid or reduce misdiagnosis.