Similarity and differences between Meniere disease and vestibular migraine: outline and epidemiology

Abstract

慢性めまい患者の身体症状について調査を行うと 頭痛が高頻度で見られた(図1)。また慢性めまい 患者301例を対象に頭痛について調査を行ったとこ ろ,頭痛が全くないのは48%で月に一回程度の頭痛 がある11%,月に二回以上頭痛があるが41%と過半 数で何らかの頭痛を認めた。また我々の別の検討で も片頭痛を有している症例が13%あった。頭痛専門 外来を受診した片頭痛患者では57.1%(176/308) と緊張型頭痛患者と比較して有意に多くめまい症状 の合併を認めた(図2)。海外の報告でも前兆の ない片頭痛(N=60)では70%,前兆のある片頭痛 (N=60)85%,慢性片頭痛(N=60)85%,であ りコントロール(N=60)では12%だった。 メニエール病と前庭性片頭痛の診断基準 メニエール病は反復するめまい,耳鳴,難聴を主 症状とする疾患でその病態は内リンパ水腫である。 各国で様々な診断基準(表1,2,3)が提唱され Patients with chronic dizziness often complain of headache; conversely, patients with headache complain of dizziness. Patients with migraine complain of dizziness more often than patients with tension-type headache. Diagnostic criteria for both Meniere disease and vestibular migraine have been reported recently. However, in some cases, it is difficult to clearly distinguish between Meniere’s disease and vestibular migraine. In the patients complains symptom, which is described in the diagnostic criteria of Meniere disease and vestibular migraine at the same time may define as Patients complaining of symptoms described in both the diagnostic criteria for Meniere’s disease and vestibular migraine may be defined as having vestibular migraine and Meniere’s disease overlap syndrome. Here, I would like to describe the etiology of migraine and Meniere’s disease. In Japan, migraine is reported to occur at a prevalence of 3.6 % in men and 12.9% in women, while Meniere’s disease is reported to occur at a prevalence of approximately 2―30 cases per 1,000,000 inhabitants. In otorhinolaryngologic? outpatient practice, Meniere’s disease and vestibular migraine are reported to account for about 8%―10% of patients. There are no objective tools yet to clearly diagnose either vestibular migraine or Meniere’s disease. Recently, the habituation of middle latency response was reported as a potential objective evaluation tool for the diagnosis of vestibular migraine. Further study is required to identify objective tools for the diagnosis of vestibular migraine and Meniere’s disease. パネルディスカッション「メニエール病と前庭性片頭痛:その類似点と相違点,関係性」