在最近的一次回顾性研究,偏头痛患者头晕或眩晕的历史被要求评价治疗反应的头痛和头晕/眩晕antimigrainous药物。(10)的子群七偏头痛患者眩晕了舒马曲坦的历史,认为这不仅有效地改善头痛,而且治疗眩晕。这项研究有几个方法学问题但对应于我们的经验,对流产药物可以有效偏头痛的眩晕。然而,并不是所有明确的偏头痛的患者眩晕在我们的研究的候选药物,因为除了禁忌症的药物,必须考虑到口服药物不合理选择攻击持续不到一个小时。皮下或鼻管理在某些情况下可能是一个选项。总的来说,我们认为,现有的证据能够证明个体患者的治疗试验,但随机临床试验需要澄清的作用药物治疗偏头痛的眩晕。成衣的博士建议我们应该考虑精神并发症的偏头痛,即恐慌症。然而,他没有解释如何恐慌症的发病率和偏头痛可能会影响我们的研究的结果。恐慌症的关系与头晕和眩晕是复杂的。一方面,nonvestibular头晕可能是恐慌症的症状,而另一方面,有一个前庭症状和恐慌症的发病率增加。 (11) This, however, should not lead to the conclusion that panic disorder itself can present with true vertigo. Therefore, an important aspect in the differentiation of definite/probable migrainous vertigo and panic disorder is the vestibular vs. nonvestibular type of dizziness as defined in our proposed diagnostic criteria. One of the main results of our study is that patients with dizziness/vertigo have a higher migraine prevalence than controls. Dr. Preter seems to suggest that the high prevalence of migraine in the dizziness clinic group may be attributed to a subgroup of patients with psychogenic dizziness who may have an increased prevalence of migraine. However, in our dizziness clinic group, contrary to Dr. Preter’s calculation, patients with vestibular symptoms contribute more to the high migraine prevalence than patients with nonvestibular dizziness, including panic disorder, as can be seen in Table 2 of our original paper.
7所示。哈克拉,Rassekh CH。情景眩晕在基部的动脉偏头痛。Otolaryngol头颈外科杂志1987;96:239 - 250。8。布兰德兹•M t .情景性眩晕与偏头痛(90例):前庭偏头痛?J神经1999;246:883 - 892。9。Behan阿宝,卡林j .良性复发性眩晕。:玫瑰FC。偏头痛研究的进展和治疗。纽约:乌鸦,1982:49-55。 10. Bikhazi P, Jackson C, Ruckenstein MJ. Efficacy of antimigrainous therapy in the treatment of migraine-associated dizziness. Am J Otol 1997;18:350-354. 11. Simon NM, Pollack MH, Tuby KS, Stern TA. Dizziness and panic disorder: a review of the association between vestibular dysfunction and anxiety. Ann Clin Psychiatry 1998;10:75-80
我们感谢招聘博士提出的问题治疗偏头痛的眩晕。现有证据由一系列小案例的病人与心得安预防antimigraine治疗反应很好(7)美托洛尔(8)、苯噻啶(9)、麦角胺(7、8)或氟桂利嗪。(8)然而,没有随机临床试验。
在最近的一次回顾性研究,偏头痛患者头晕或眩晕的历史被要求评价治疗反应的头痛和头晕/眩晕antimigrainous药物。(10)的子群七偏头痛患者眩晕了舒马曲坦的历史,认为这不仅有效地改善头痛,而且治疗眩晕。这项研究有几个方法学问题但对应于我们的经验,对流产药物可以有效偏头痛的眩晕。然而,并不是所有明确的偏头痛的患者眩晕在我们的研究的候选药物,因为除了禁忌症的药物,必须考虑到口服药物不合理选择攻击持续不到一个小时。皮下或鼻管理在某些情况下可能是一个选项。总的来说,我们认为,现有的证据能够证明个体患者的治疗试验,但随机临床试验需要澄清的作用药物治疗偏头痛的眩晕。成衣的博士建议我们应该考虑精神并发症的偏头痛,即恐慌症。然而,他没有解释如何恐慌症的发病率和偏头痛可能会影响我们的研究的结果。恐慌症的关系与头晕和眩晕是复杂的。一方面,nonvestibular头晕可能是恐慌症的症状,而另一方面,有一个前庭症状和恐慌症的发病率增加。 (11) This, however, should not lead to the conclusion that panic disorder itself can present with true vertigo. Therefore, an important aspect in the differentiation of definite/probable migrainous vertigo and panic disorder is the vestibular vs. nonvestibular type of dizziness as defined in our proposed diagnostic criteria. One of the main results of our study is that patients with dizziness/vertigo have a higher migraine prevalence than controls. Dr. Preter seems to suggest that the high prevalence of migraine in the dizziness clinic group may be attributed to a subgroup of patients with psychogenic dizziness who may have an increased prevalence of migraine. However, in our dizziness clinic group, contrary to Dr. Preter’s calculation, patients with vestibular symptoms contribute more to the high migraine prevalence than patients with nonvestibular dizziness, including panic disorder, as can be seen in Table 2 of our original paper.
7所示。哈克拉,Rassekh CH。情景眩晕在基部的动脉偏头痛。Otolaryngol头颈外科杂志1987;96:239 - 250。8。布兰德兹•M t .情景性眩晕与偏头痛(90例):前庭偏头痛?J神经1999;246:883 - 892。9。Behan阿宝,卡林j .良性复发性眩晕。:玫瑰FC。偏头痛研究的进展和治疗。纽约:乌鸦,1982:49-55。 10. Bikhazi P, Jackson C, Ruckenstein MJ. Efficacy of antimigrainous therapy in the treatment of migraine-associated dizziness. Am J Otol 1997;18:350-354. 11. Simon NM, Pollack MH, Tuby KS, Stern TA. Dizziness and panic disorder: a review of the association between vestibular dysfunction and anxiety. Ann Clin Psychiatry 1998;10:75-80