전정편두통, 얼마나 정확하게 진단할 수 있나? 어지럼 환자들을 대상으로 외래 진료 중전정편두통으로 평가한 경우와 바라니학회 및 Neuhasuer 진단 기준을 적용할 때의 유병률 차이
Vestibular Migraine, How Accurately Can It Be Diagnosed? Prevalence of Preliminary Clinical Diagnosis at a Dizziness Clinic and Prevalence Based on Bárány and Neuhauser Diagnostic Criteria
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Background and Objectives Vestibular migraine (VM) is considered to be one of the mostcommon causes of episodic vertigo. The diagnosis for VM must be confirmed by a complexset of diagnostic criteria set by the Bárány Society (BS) which includes the definition of ves-tibular symptoms, number, intensity, and duration of dizziness, a history of migraine accord-ing to the International Classification of Headache Disorders, 3rd edition, and the co-occur-rence of vertigo and migraine. Should all these conditions be met, the actual prevalenceevaluated at a clinic would be much lower than previously known or estimated. In this study,we aimed to compare the prevalence of VM based on different diagnostic criteria, the BS cri-teria and the previous Neuhauser criteria. They were compared with the prevalence of the pre-liminary clinical diagnosis during an outpatient visit. Subjects and Method The medical records of new patients who presented dizziness who atthe clinic from December 2018 to November 2020 were reviewed. The patients completed aquestionnaire designed to identify VM according to the BS criteria. Cases meeting the BS orNeuhauser criteria and those described as VM in the clinical impression of the medical re-cords were identified. Results During the study period, 955 patients presented complaining of dizziness to the oto-laryngology department. Among those patients, 11.6% were given preliminary clinical diag-nosis of VM in the outpatient clinic. However, only 2.9% were diagnosed with VM using theBS criteria, and the prevalence was 9.3% using the Neuhauser’s criteria. Conclusion The prevalence of VM using the BS criteria was much lower than the preva-lence of preliminary clinical diagnoses in outpatient clinics or using the previously used Neu-hauser criteria.
Abstract
Background and Objectives Vestibular migraine (VM) is considered to be one of the mostcommon causes of episodic vertigo. The diagnosis for VM must be confirmed by a complexset of diagnostic criteria set by the Bárány Society (BS) which includes the definition of ves-tibular symptoms, number, intensity, and duration of dizziness, a history of migraine accord-ing to the International Classification of Headache Disorders, 3rd edition, and the co-occur-rence of vertigo and migraine. Should all these conditions be met, the actual prevalenceevaluated at a clinic would be much lower than previously known or estimated. In this study,we aimed to compare the prevalence of VM based on different diagnostic criteria, the BS cri-teria and the previous Neuhauser criteria. They were compared with the prevalence of the pre-liminary clinical diagnosis during an outpatient visit. Subjects and Method The medical records of new patients who presented dizziness who atthe clinic from December 2018 to November 2020 were reviewed. The patients completed aquestionnaire designed to identify VM according to the BS criteria. Cases meeting the BS orNeuhauser criteria and those described as VM in the clinical impression of the medical re-cords were identified. Results During the study period, 955 patients presented complaining of dizziness to the oto-laryngology department. Among those patients, 11.6% were given preliminary clinical diag-nosis of VM in the outpatient clinic. However, only 2.9% were diagnosed with VM using theBS criteria, and the prevalence was 9.3% using the Neuhauser’s criteria. Conclusion The prevalence of VM using the BS criteria was much lower than the preva-lence of preliminary clinical diagnoses in outpatient clinics or using the previously used Neu-hauser criteria.
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