| 【Background】Vestibular migraine(VM)is one of the most common clinical vertigo diseases,and it is the second most common vertigo-related disease,after Benign Paroxysmal Positional Vertigo(BPPV).Although there are many studies based on the clinical characteristics of patients with vestibular migraine,its etiology and pathogenesis still need to be further explored.At present,the diagnosis of VM is mainly based on the medical history,and there is no objective laboratory examination to confirm the diagnosis.However,in recent years,the examination of vestibular function has been widely used in vestibular related diseases,and it has certain guiding significance in clarifying the vestibular function and its damaged parts.Vestibular Evoked Myogenic Potentials(VEMPs)include cervical Vestibular Evoked Myogenic Potential(cVEMP)and ocular Vestibular Evoked Myogenic Potential(oVEMP),respectively,reflected the function of saccule and utricle.In VM patients,VEMPs can help clarify the patient’s vestibular function and distinguish them from other vestibular diseases.Most patients with VM have photophobia and phobia of sound and intense flash stimulation can also induce the seizure of VM,and the pathway and mechanism involved are not clear yet.At the same time,the study on the effect of flash stimulation on VEMPs in VM patients has not been reported.Treatment of VM mainly includes oral drug therapy and vestibular rehabilitation therapy(VRT),and vestibular rehabilitation is also helpful to the formation of central compensations in patients,so it is necessary to further study the effect of vestibular rehabilitation on VEMPs.To evaluate the efficacy of vestibular rehabilitation in VM treatment.【Objective】Through the vestibular function examination technique,we explored the characteristics and regularity of VEMPs results of vestibular migraine and the influence of flash stimulation on them,in order to reveal the diagnostic value of VEMPs in VM.To study the therapeutic effect of vestibular rehabilitation in the treatment of VM,and analyze the significance of vestibular function examination in the evaluation of the therapeutic effect of VM,so as to provide objective basis for the formulation of treatment plan and the establishment of management strategy of vestibular function recovery in VM patients.【Subjects and method】1.Fifty-four patients with vestibular migraine were divided into study group(1)(26 cases)and study group(2)(28 cases).Study group(1)received oral drug therapy alone;Study group(2)oral drugs combined with vestibular rehabilitation treatment;The amplitude,latency and asymmetry ratio of VEMPs were compared with those in the migraine group(11 cases)and the normal control group(45cases).2.VEMPs were examined before and after flash stimulation in the VM group,the migraine group and the normal control group at admission,and the changes of amplitude,latency and asymmetry ratio of VEMPs before and after flash stimulation in the three groups were compared.3.VM patients were followed up to compare the changes of VEMPs and DHI scores between the drug therapy alone group and the drug combined vestibular rehabilitation group at admission,1 week after treatment and 1 month after treatment.4.The results of VEMPS before and after flash stimulation and treatment were analyzed,as well as the changes in DHI scores of VM patients before and after treatment.【Results】1.The abnormal rate of CVEMP,the abnormal rate of OVEMP and the total abnormal rate of VEMPs in the vestibular migraine group were higher than those in the migraine group and the normal control group(P<0.0167);The amplitude of VEMPs in the vestibular migraine group was lower than that in the normal control group(P<0.05);The asymmetry of VEMPs in the vestibular migraine group was higher than that in the migraine group and the normal control group(P<0.05).2.After treatment,the amplitude of VEMPs in the group with vestibular migraine increased,and the asymmetry ratio decreased or even returned to normal,but there was no significant change in VEMPs in the group with drug therapy alone and the group with drug combined vestibular rehabilitation after 1 week and 1 month of treatment.There was no difference in DHI score after 1week of treatment between the drug therapy alone group and the drug combined vestibular rehabilitation group,but the changes of DHI score after 1 month of treatment were lower than those of the control group(P<0.05).3.There was no significant correlation between VEMPs and DHI scores in both groups with vestibular migraine.4.There was no significant correlation between the VEMPs before and after flash stimulation between the vestibular migraine group and the migraine group and the normal control group.【Conclusions】1.The abnormal rate of VEMPs in VM patients was high and the amplitude showed a decreasing trend,suggesting that VEMPs had certain value in the objective evaluation of vestibular function in patients with vestibular migraine.2.There was no significant correlation between the results of VEMPs in VM patients before and after flash stimulation,so the pathogenesis and the potential mechanism of photophobia in VM patients under flash stimulation still need to be further studied.3.Vestibular rehabilitation and drug therapy alone are equally effective for vestibular migraine. |
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