Abstract: Objective To assess migraineurs' vestibular function and reflex pathway of occular-brainstem-cervical muscle by recording and analysing vestibular evoked myogenic potential (VEMP), and discuss the VEMP clinical value. Methods VEMP and different kinds of manifestation were investigated in 39 migraineurs. According to clinical characteristics, migraineurs were divided into several subgroups with or without aura, male or female, and with or without positive family history. The results of VEMP were compared between subgroups. Results There were 13 of 39 migraineurs' VEMP abnormal and the abnormal rate was 33.33%: 4 migraineurs without response bilaterally, one migraineur without response on one side and with decreased amplitude on the other side, 2 migraineurs with decreased amplitude bilaterally, and 6 migraineurs with increased ratio of bilateral amplitude or asymmetry. The latency of P13 and N23 of the patients were all in normal range. The difference of abnormal VEMP rate in migraineurs with aura (28.57%, 4/14) and that in migraineurs without aura (36%, 9/25) was not significant (χ2 = 0.014, P = 0.906). No significant difference was seen between the rate of abnormal VEMP in male (30%, 3/10) and that in female (34.48%, 10/29; χ2 = 0.017, P = 0.897). There was significant difference between the abnormal VEMP rate in patients with positive family history (66.67%, 8/12) and that without family history (18.52%, 5/27; χ2 = 6.635, P = 0.001). Conclusion Migraineurs' vestibular function may exist abnormal subclinical features which mainly indicate the asymmetry in bilateral reflex pathway of occular-brainstem-cervical muscle. Migraineurs with positive family history are prone to present this abnormality. VEMP may be a clue in the selection of prophylactic agents for migraineurs.

Key words: Migraine, Vestibular nerve, Vestibular function tests, Evoked potentials

摘要： 目的   通过前庭诱发肌源性电位评价偏头痛患者的前庭功能、球囊?脑干?颈肌反射通路状态，并探讨其临床价值。方法   应用前庭诱发肌源性电位检测39 例偏头痛患者的前庭功能，并根据有无先兆发作、性别和有无偏头痛家族史，比较不同亚组偏头痛患者前庭诱发肌源性电位的差异性。结果   39 例偏头痛患者中13 例前庭诱发肌源性电位检测异常，异常率约为33.33%，但P13 波和N23 波潜伏期均于正常值范围。不同亚组比较，有偏头痛家族史患者前庭诱发肌源性电位检测异常率显著高于无家族史者（χ2 = 6.635，P = 0.001）；而有无先兆发作和性别等亚组之间差异无统计学意义（χ2 = 0.014，P = 0.906；χ2 = 0.017，P = 0.897）。结论   偏头痛患者前庭功能存在亚临床损害，主要表现为双侧球囊-脑干-颈肌反射通路不对称性，有偏头痛家族史患者更容易出现异常改变。前庭诱发肌源性电位检查可以作为偏头痛患者预防性治疗药物选择的一项依据。

关键词: 偏头痛, 前庭神经, 前庭功能试验, 诱发电位