單側椎動脈發育不全與偏頭痛性眩暈

Unilateral Vertebral Artery Hypoplasia and Migrainous Vertigo

椎動脈發育不全可能會影響偏頭痛，也可能會影響偏頭痛性眩暈，但是，這類的文獻仍然有限。2名分別為40及36歲女性，均因長期反覆出現眩暈、頭痛、噁心、嘔吐、畏聲及畏光，前者還合併有視力模糊、運動失調及軀體感覺異常，兩病例均無暈厥或肢體無力，對於抗偏頭痛藥物的反應良好。兩耳溫差測試均無異常發現，但是，眼振電圖與前庭誘發肌性電位檢查均呈現異常。頸部血管超音波與腦部磁振造影均顯示右側椎動脈發育不全，尚無其他中樞神經性的病灶。最後，他們均為抗偏頭痛藥物所治癒，分別診斷為 1） 基底型偏頭痛之偏頭痛性眩暈與 2） 無預兆偏頭痛之偏頭痛性眩暈，兩者均合併椎動脈發育不全。爾後不僅需避免病症發作，均建議長期服用抗血小板劑，以避免後顱窩循環缺血性中風之風險。

Vertebral artery hypoplasia (VAH) may influence migraines, and may also have some bearing on migrainous vertigo (MV), but the research literature is limited. Two female patients, one 40- and one 36-years-old presented with frequent attacks of vertigo, headache, nausea, vomiting, photophobia and phonophobia for a period of time. The patients also previously suffered from visual disturbances, ataxia, and paresthesia, though they did not suffer from syncope or muscle weakness. Caloric tests were normal, but electronystagmogram and vestibular evoked myogenic potentials were revealed as abnormal. Duplex scanning of neck vessels and magnetic resonance images revealed right VAH instead of other central lesions. Finally, they were cured by anti-migraine therapy, and respectively diagnosed with: 1) MV of basilar-type migraine and 2) MV of migraine without aura, and they both had VAH. The recurrence of MV should then be prevented, but a daily use of anti-platelet was also recommended to lower the risk of posterior circulation ischemia.