Vestibüler migrenli hastalarda vestibüler rehabilitasyon
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Dosyalar
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve amaç: Vestibüler migren (VM), migren öyküsü olan hastalarda epizodik vertigo
atakları ile giden bir hastalıktır. Migrende proflaktik tedaviler VM’de de kullanılmaktadır.
Vestibüler rehabilitasyon (VR)’un, VM hastalarında vestibüler semptomlar için alternatif
tedavi olması ön görülmektedir. Çalışmamızda VR tedavisinin etkinliğinin gösterilmesi
amaçlanmıştır.
Gereç ve yöntem: Çalışmaya 77 hasta alındı. 17 hasta çalışmayı tamamlayamadı.20 hastadan
oluşan, 3 farklı tedavi grubu oluşturuldu. Hastalar gruplara randomize dağıtıldı. Bir gruba
sadece VR(SR) tedavisi, bir gruba VR ile birlikte migren proflaksisi(R+P) ve bir gruba da
sadece migren proflaksisi(SP) verildi. Hastaların demografik verileri, baş ağrısı ve baş
dönmesi özellikleri, baş dönmesine eşlik eden semptomlar, vertigo tipi sorgulandı. Kalorik
test, odyometri ve statik postürografi (modified CTSIB) yapıldı. Aktivitelere özgü denge
güven ölçeği (ABC) ve baş dönmesi özürlülük ölçeği (DHI) dolduruldu. Hastalar 3. ve 6.
aylarda kontrol edildi.
Bulgular: Hastaların ortalama yaşı 43,6 yıldı. 54 hasta kadındı. Hastaların % 68,3’ü spontan
tip, % 26,7’ si pozisyonel tip vertigo tarifledi. Kalorik test hastaların % 85’ inde normal,
odyometride hastaların 2’ sinde tek taraflı işitme azlığı şeklinde saptandı. Baş ağrısı atak
sıklığında; SR alan grupta % 44, S+P alan grupta % 79.4, SP alan grupta % 85.4 azalma
izlendi. Baş dönmesi atak sıklığında: SR alan grupta % 87,6, S+P alan grupta % 88,7 , SP alan
grupta % 61,3 azalma izlendi. Postürografi kayıtlamalarında rehabilitasyon alan gruplarda
iyileşme izlendi. Tüm gruplarda ABC ölçeklerinde ortalama 17,8 puan artış, DHI ölçeklerinde
ortalama 21,2 puan azalma gözlendi.
Sonuç: VR’un VM hastalarında baş ağrısı ve baş dönmesi atak sıklık, süre ve şiddetlerinde
azalma sağladığı görülmüştür. Vestibüler semptomları ön planda olan hastalarda tek başına
VR tedavisi uygulanabilir. SP tedavisi vestibüler semptomlar üzerine VR kadar etkili değildir.
Hem baş ağrısı hem baş dönmesi yakınmaları ön planda olan hastalarda R+P tedavisi
kombinasyonu uygun bir seçenek olarak görülmüştür.
İntroduction and intention: Vestibular migraine(VM) is a disease characterized by attacks of vertigo in patients with a history of migraine. Migraine prophylactic treatments can use in VM. Vestibular rehabilitation is expected to be an alternative treatment for vestibular symptoms in VM patients. This study aimed to demonstrate the effectiveness of VR in VM. Materials and Methods: 77 patients were included to study. 17 patients failed to complete the study. 3 different treatment groups were formed consisting of twenty patients. Patients were randomly distributed into groups. First group was treated just vestibular rehabilition(JR), another group was treated with rehabilition and migraine prophylactic drugs(R+P), last group was treated with just migraine prophylactic drugs(JP). The demographic data of patients, headache and dizziness features, associated symptoms and vertigo type was questioned. Caloric testing, audiometry and static posturography was performed. Activity-specific balance confidence scale(ABC) and dizziness handicap inventory(DHI) was completed. Patients was controlled in the third and sixth months. Results: The mean age of the patients was 43.6 years. 54 patients were female. 68.3% of patients with spontaneous type vertigo, 26.7% of patients with positional type vertigo was describing. 85 percent of patients with normal caloric test. İn two patients sided hearing loss was found in audiometry. Headache frequency decrease was observed in the groups; 44% in JR, 79.4% in R+P, 85.4% in JP. Dizziness frequency decrease was observed in the groups; 87.6% in JR, 88.7% in R+P, 61.3% in JP. Posturography improvement was observed in the group receiving rehabilitation treatment. İn all groups, ABC scale increased by an average of 17.8 points, DHI scales decreased by an average of 21.2 points Conclusion: The frequency, duration and severity of headache and dizziness attacks have been found decrease with vestibular rehabilitation. JR therapy can be applied in patients with vestibular symptoms in the foreground. JP therapy is not as effective as the treatment of vestibular rehabilitation on vestibular symptoms. Rehabilitation and treatment of migraine prophylaxis combination was seen as a viable option for headaches and dizziness in patients in the foreground.
İntroduction and intention: Vestibular migraine(VM) is a disease characterized by attacks of vertigo in patients with a history of migraine. Migraine prophylactic treatments can use in VM. Vestibular rehabilitation is expected to be an alternative treatment for vestibular symptoms in VM patients. This study aimed to demonstrate the effectiveness of VR in VM. Materials and Methods: 77 patients were included to study. 17 patients failed to complete the study. 3 different treatment groups were formed consisting of twenty patients. Patients were randomly distributed into groups. First group was treated just vestibular rehabilition(JR), another group was treated with rehabilition and migraine prophylactic drugs(R+P), last group was treated with just migraine prophylactic drugs(JP). The demographic data of patients, headache and dizziness features, associated symptoms and vertigo type was questioned. Caloric testing, audiometry and static posturography was performed. Activity-specific balance confidence scale(ABC) and dizziness handicap inventory(DHI) was completed. Patients was controlled in the third and sixth months. Results: The mean age of the patients was 43.6 years. 54 patients were female. 68.3% of patients with spontaneous type vertigo, 26.7% of patients with positional type vertigo was describing. 85 percent of patients with normal caloric test. İn two patients sided hearing loss was found in audiometry. Headache frequency decrease was observed in the groups; 44% in JR, 79.4% in R+P, 85.4% in JP. Dizziness frequency decrease was observed in the groups; 87.6% in JR, 88.7% in R+P, 61.3% in JP. Posturography improvement was observed in the group receiving rehabilitation treatment. İn all groups, ABC scale increased by an average of 17.8 points, DHI scales decreased by an average of 21.2 points Conclusion: The frequency, duration and severity of headache and dizziness attacks have been found decrease with vestibular rehabilitation. JR therapy can be applied in patients with vestibular symptoms in the foreground. JP therapy is not as effective as the treatment of vestibular rehabilitation on vestibular symptoms. Rehabilitation and treatment of migraine prophylaxis combination was seen as a viable option for headaches and dizziness in patients in the foreground.
Açıklama
Anahtar Kelimeler
Vestibüler Migren, Vestibüler Rehabilitasyon, Vertigo, Migren, Rehabilitasyon, Vestibular Rehabiltion, Vestibular Migraine, Migraine, Rehabilition
