合併疑似單側腦幹病變之可能偏頭痛性眩暈:病例報告

摘要

「可能偏頭痛性眩暈」與偏頭痛性眩暈有關,若病程發生變化時,應考慮中樞性的病變,若對影像學的檢查結果有疑慮時,可以借助神經耳科學的方法。一28歲男性,苦於左側耳鳴及聽障已經7年,自1年前開始罹患「可能偏頭痛性眩暈」,每每於發作前左側耳鳴會加重。大約在半年前的一次發作時,左側耳鳴加重及頭暈持續了3週,磁振造影顯示左側中腦出現了可疑處,由於眼振電圖、兩耳溫差測試及左側前庭誘發肌性電位檢查呈現異常,而且在給予腦循環促進劑治療後,聽力均有進步,可見當時應有左側腦幹的病變。爾後半年,在適當地使用鎮定劑或助眠劑後,情況依然穩定。

關鍵字

頭暈 ; 耳鳴 ; 可能偏頭痛性 ; 眩暈 ; 腦幹病變

並列摘要

Probable migrainous vertigo (probable MV) is relative with migrainous vertigo (MV). A central lesion should be impressed if the disease-course changes. An oto-neurologic study is recommended to confirm a dubious image finding. A 28-year-old male presented left tinnitus and hearing block for 7 years. Unfortunately, he has been bothered with probable MV since one year ago. Left tinnitus always exacerbated before each attack. However, about half a year ago, left exacerbated tinnitus and dizziness has persisted for three weeks. Magnetic resonance image/angiogram of brain showed a dubious finding in his left midbrain. Electrony-stagmogram, caloric test and left vestibular evoked myogenic potential showed abnormal waves; in addition, his hearing ability improved after treated with a brain circulatory promoter, so there must be something wrong in his left brainstem. In the following half a year, it was uneventful because a sedative or a hypnotics has been properly used.

並列關鍵字

dizziness ; tinnitus ; probable migrainous vertigo ; brainstem lesion

延伸閱讀

陳建志、鄭若詩、陳登郎(2013)。一病例報告:周邊性眩暈續發外側延髓及小腦梗塞。台灣家庭醫學雜誌,23(3),142-148。https://doi.org/10.3966/168232812013092303004
陳建志、劉智仰、陳登郎、楊菁華(2010)。良性陣發性姿態性眩暈症與典型預兆非偏頭痛性頭痛。童綜合醫學雜誌,4(1),42-48。https://www.airitilibrary.com/Article/Detail?DocID=20713592-201006-201101270002-201101270002-42-48
陳建志、陳登郎(2009)。單側椎動脈發育不全與偏頭痛性眩暈。秀傳醫學雜誌,9(1&2),61-66。https://www.airitilibrary.com/Article/Detail?DocID=15610497-200906-201002080061-201002080061-61-66
陳建志、陳登郎、陳瑞昌、楊菁華(2011)。以單側突發性耳聾為前驅症狀之典型預兆非偏頭痛性頭痛。北市醫學雜誌,8(1),61-70。https://doi.org/10.6200/TCMJ.2011.8.1.07
Hsieh, C. Y., Chen, C. H., & Chang, T. P. (2010). Isolated Brainstem Involvement in a Patient with Hypertensive Encephalopathy. Acta Neurologica Taiwanica, 19(1), 45-50. https://doi.org/10.29819/ANT.201003.0007

國際替代計量

合併疑似單側腦幹病變之可能偏頭痛性眩暈:病例報告

陳建志、劉智仰、孫盛義、陳登郎(2010)。合併疑似單側腦幹病變之可能偏頭痛性眩暈:病例報告。南臺灣醫學雜誌,6(1),58-64。https://doi.org/10.6726/MJST.201006_6(1).0009