Postural control at posturography with virtual reality in the intercritical period of vestibular migraine

Cesaroni, Suelen; Silva, Adriana Marques da; Ganança, Maurício Malavasi; Caovilla, Heloísa Helena

doi:10.1016/j.bjorl.2019.06.015

Cited by 11 publications

(17 citation statements)

References 27 publications

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“…Although no pathognomonic laboratory test that can verify a VM diagnosis exists, investigations should be done to rule out any other diagnosis. Many authors report minor signs of peripheral and central vestibular dysfunction, including pathological results in caloric and video head impulse testing (vHIT) as well as in tonal audiometry, cervical and ocular vestibular evoked myogenic potentials (VEMP), posturography or magnetic resonance imaging (MRI), but the findings are ambiguous [61,[63][64][65][66][67][68][69][70][71].…”

Section: Laboratory Findingsmentioning

confidence: 99%

Vestibular migraine — an underdiagnosed cause of vertigo. Diagnosis and treatment

Nowaczewska

2020

Neurol Neurochir Pol.

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Introduction. Migraine and vertigo are two common conditions. The main disorder connecting both these entities is vestibular migraine (VM). State of the art. VM may affect 1-3% of the general population. It is a disabling disease of recurrent attacks of vestibular symptoms accompanied by migraine features which occur in patients with a current or previous history of migraine. The episodes can last minutes, hours or even days, and may occur without any concurrent headache, which can prompt misdiagnosis. VM often begins several years after a typical migraine, and the delay between onset of headache and vertigo may be long. The diagnosis is based on the patient's clinical history and can be challenging due to the lack of an established confirmatory diagnostic test or biomarkers. The mechanism of vestibular migraine remains unclear and is still under investigation, but it seems to be an interaction between trigeminal and vestibular systems. Due to the lack of specific trials, treatment recommendations are based on migraine guidelines. Several drugs seem to be effective, although there have been few randomised controlled trials in this area. Regardless of the published strict and detailed diagnostic criteria, this condition remains little known, and as a consequence is underdiagnosed and undertreated. Clinical implications. Efforts should be made to educate medical communities and patients about this disease and to encourage neurologists and ENT specialists to cooperate. Every patient with vertigo of unknown origin should be directly asked about a past or present history of migraine, or migraine symptoms experienced during their vertigo episodes. Future directions. There is a growing need for studies regarding the pathophysiology of VM as well as randomised trials to establish clear treatment recommendations and to improve management of this surprisingly common disorder.

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Section: Laboratory Findingsmentioning

confidence: 99%

Vestibular migraine — an underdiagnosed cause of vertigo. Diagnosis and treatment

Nowaczewska

2020

Neurol Neurochir Pol.

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“…All studies used valid and reliable outcome measures, which were clearly described in both the Methods and Results sections. The main source of bias included the lack of sample representativity of the entire po pulation, 5,9,10,34,35,[37][38][39]42,[44][45][46][47][48][49][50][51][52] unblinded assessor, 5,9,10,[34][35][36][40][41][42][43][44][45][46][47][48][49][50][51][52] inadequate adjustment for confounders, 9,36,40,41,44,45,[48][49][50][51] and lack of sample size justification. 9,10,34,…”

Section: Literature Search and Methodological Qualitymentioning

confidence: 99%

Postural control impairment in patients with headaches—A systematic review and meta‐analysis

et al. 2022

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ObjectiveTo summarize the evidence regarding static and dynamic balance alterations among patients with headache.MethodsElectronic databases (PubMed, CINAHL, and Web of Science) were searched by two researchers independently up to September 2021. Two reviewers selected eligible studies, extracted the data, and assessed the quality of evidence using the Downs and Black checklist. Case‐control studies were included if they involved balance assessment of any kind of headache, including objective outcome measures of dynamic and static tests such as body sway displacement, limits of stability (LOS), gait, and tandem walk tests. A meta‐analysis and post hoc sensitivity analyses were performed when possible.ResultsTwenty‐two studies (1202 patients with headache and 597 controls) were included in this review and 16 of them in the meta‐analysis. Risk of bias ranged from low to moderate among all studies. Greater sway area in static posturography was shown by patients with migraine in comparison to controls, with more consistent differences in more challenging test conditions, such as over a foam surface with eyes closed (difference of 4.8 cm2, 95% CI: 3.8–5.9). Lower performance of patients with migraine during the tandem walk test (difference of −7.8 cm/s, 95% CI: −9.0 to −6.5) and slower reaction time in the LOS test (difference of 0.3 s, 95% CI: 0.2–0.4) were also verified. There is no evidence of altered sway velocity and length in static posturography among patients with migraine (p > 0.05). The level of evidence is very low for balance alteration of any kind among patients with tension‐type and cervicogenic headache owing to the limited number of studies and high heterogeneity.ConclusionThis review confirmed the presence of static and dynamic balance alterations among patients with migraine. Future studies with low risk of bias are needed to decrease heterogeneity in methodology and explore the role of subdiagnosis on the balance of patients with headache.

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“…Тем не менее необходимость объективной оценки вестибулярной составляющей ВМ остается. Различные типы постурографии, стабилометрии, в том числе и с виртуальной реальностью, используются для оценки баланса у пациенс мигренью и вестибулярной дисфункцией, выявления сомато сенсорных, вестибулярных и зрительных изменений, изолированных или комбинированных [5,9,13].…”

Section: показатели / Parameterunclassified

“…Чувствительность стабилометрических тестов и качество получаемой информации позволяют применять этот метод для определения функционального состояния пациентов, в том числе пациентов с мигренью [5,[7][8][9][10]. Вопрос об оптимальном наборе стабилометрических тестов, позволяющих четко зафиксировать особенности дисбаланса и специфические маркеры ВМ, остается открытым.…”

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Assessment of the Balance and Dizziness Objectification in Patients with Vestibular Bilous Headache

Illarionova¹,

Gribova²

2021

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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.

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Postural control at posturography with virtual reality in the intercritical period of vestibular migraine

Cited by 11 publications

References 27 publications

Vestibular migraine — an underdiagnosed cause of vertigo. Diagnosis and treatment

Vestibular migraine — an underdiagnosed cause of vertigo. Diagnosis and treatment

Postural control impairment in patients with headaches—A systematic review and meta‐analysis

Assessment of the Balance and Dizziness Objectification in Patients with Vestibular Bilous Headache

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