內耳型偏頭痛的臨床類型

Clinical Types of Inner Ear Migraine

前庭性偏頭痛對人們的影響甚鉅，就先前的統計，偏頭痛大約影響了1-2.7%的人口，其五花八門的症狀更是時常讓臨床工作者難以辨別，雖然目前前庭性偏頭痛已有一套診斷標準，但我們可以發現有一群患者狀況非常貼近前庭性偏頭痛，但卻因當前的診斷標準相對嚴苛的性質，而無法被歸類在其中。另外，部分病人還會包含有聽力波動或耳嗚的狀況，因此我們就自身多年的臨床經驗，將前庭性偏頭痛的觀念更進一步延伸，稱為內耳型偏頭痛，當中包含6項分類：前庭性偏頭痛（vestibular migraine, VM）、偏頭痛相關之暈眩（migraine associated dizziness, MAD）、良性反覆性眩暈（benign recurrent vertigo, BRV）、耳蝸性偏頭痛（cochlear migraine, CM）、耳蝸前庭性偏頭痛（cochlear vestibular migraine, CVM）、偏頭痛相關之梅尼爾氏症（migraine related Ménière’s disease, MRMD），藉由這6項分類來更精準的歸類病人，得到適當的治療。

Vestibular migraine affects many people, with previous statistics showing that migraine affects approximately 1-2.7% of the population. The wide variety of symptoms often makes it difficult for clinicians to identify. Although there are currently established diagnostic criteria for vestibular migraine, we can find a group of patients who have conditions very closely resembling vestibular migraine but cannot be classified as such due to the relatively stringent nature of the current diagnostic criteria. Some of the patients also suffered from hearing fluctuation or tinnitus. Therefore, we have further extended the concept of vestibular migraine to the inner ear migraine, which includes six categories: vestibular migraine (VM), migraine associated dizziness (MAD), benign recurrent vertigo (BRV), cochlear migraine (CM), cochlear vestibular migraine (CVM), and migraine associated M􀃪ni􀃩re’s disease (MRMD). These six classifications are used to more accurately classify patients so that they can receive appropriate treatment.