Study Objective: To study the balance in patients with vestibular bilious headache (BH) and possible use of a special comprehensive stabilometrical program for dizziness objectification in them. Study Design: open comparative study. Materials and Methods. The study included 188 patients. Group 1 were 94 patients with confirmed BH (according to the International Headache Classification). Group 2 were 94 patients with common migraine. The stabilometrical control group included 94 healthy subjects. The balance and dizziness objectification were assessed using a special comprehensive method comprising a set of stabilometrical tests. Study Results. The most marked changes in stabilometrical parameters were recorded in patients with BH. Primary frequency spectra of these patients were in a range of 0.3 Hz and above 2 Hz, showing the dysfunction of the postural system and vestibular component in particular. The rate of pressure centre deviation and statokinesigram area were increased in the patients from group 2 vs controls; however, statistically significant differences were noted only in opticokinetic test, sensory and vestibular, and closed-eye tandem results. Comparison of the two clinical groups demonstrates significant differences in basic stabilometrical parameters of all challenge tests. Visual control exclusion as well as substandard visual stimulation had significant impact on changes in the analysed parameters. Conclusion. The use of special stabilometrical tests (opticokinetic stimulation, sensory and vestibular and tandem tests) described in this article allows assessing the balance, quantifying vestibular dysfunction in patients with BH, and objectifying dizziness. Keywords: dizziness, balance, vestibular migraine, computer-aided stabilometry.
Aim: to study the possibilities of vestibular component correction in patients with vestibular migraine using external trigeminal nerve stimulation. Patients and Methods: the study included 42 patients (32 of them women) aged 18 to 50 y.o., with established vestibular migraine. All patients underwent external trigeminal nerve stimulation. The duration of each therapeutic course was 20 minutes, the frequency was 3 times a week for 3 months. The assessment of the condition dynamics was conducted using the Dizziness Handicap Inventory (DHI), Subjective Vestibular Assessment on a 5-point scale and Vestibular Rehabilitation Benefit Questionnaire. Results: at the first visit, the majority (77%) of patients suffered from severe dizziness, 23% of patients experienced moderate symptoms. After treatment, most patients experienced only mild symptoms of dizziness, while 31% of patients had no symptoms of dizziness. The total score for DHI before treatment was 58 (95% CI 54–63), after treatment — 19 (95% CI 16–24) (p<0,05). The median indicator of life quality deficiency according to the Vestibular Rehabilitation Benefit Questionnaire before correction of vestibular dysfunction was 57 (95% CI 51.3–64.8), after external stimulation course — 38 (95% CI 32.7–44.6) (p<0.05). Conclusion: external trigeminal nerve stimulation can be considered as an actual non-pharmacological method of vestibular dysfunction correction in patients with vestibular migraine. KEYWORDS: vestibular dysfunction, dizziness, vestibular migraine, external trigeminal nerve stimulation, life quality. FOR CITATION: Illarionova E.M., Gribova N.P. The effect of external trigeminal nerve stimulation on the vestibular component correction in patients with vestibular migraine. Russian Medical Inquiry. 2021;5(10):683–686 (in Russ.). DOI: 10.32364/2587-6821-2021-5-10-683-686.
The search for possible ways to minimize dizziness in patients with vestibular migraine is especially relevant in the aspect of individualized complex vestibular rehabilitation.
Aim. To study the possibilities of complex individualized vestibular rehabilitation in patients with vestibular migraine.
Material and methods. The study included 122 patients (40 men and 82 women) aged 18 to 50 years, with significant vestibular migraine. We used the Dizziness Handicap Inventory scale for assessing dizziness and a 5-point Scale for subjective assessment of the severity of dizziness and a special complex method including a set of vestibular exercises, a method of the computer stabilometry with biofeedback. Objective control of vestibular rehabilitation was carried out with the help of stabilometric testing.
Results and discussion. Positive dynamics were observed when analyzing the data of the physical, functional and emotional subscales of the Dizziness Handicap Inventory and the Scale of Subjective Assessment of the Dizziness Severity. In addition, the presented stabilometric diagnostics made it possible to fix the difference between the initial condition of patients with vestibular dysfunction and after 3 months of the special vestibular rehabilitation.Тhere was a statistically significant decrease in the basic stabilometric parameters: the area of the statokinesiogram (median area, mm² – 254 (95% CI 222-285)) and the rate of deviation of the center of pressure (median speed, mm/s – 21 (95% CI 17-24)) as well as a decrease in the shifts of the spectrum energy in the low-frequency and high-frequency spectrum that indicates an improvement in stability. The presented method for influencing the compensatorycapabilities of regulatory mechanisms in patients with vestibular migraine positively affects the efficiency of the equilibrium system as a whole, optimizing postural stability in this category of patients.
Conclusion. An individually selected comprehensive program of vestibular gymnastics and hardware rehabilitation techniques on the stabilographic platform with biofeedback helps to improve postural stability and minimize dizziness in patients with vestibular migraine.
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