Clinical features and associated syndromes of mal de debarquement
Clinical features and associated syndromes of mal de debarquement
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DOI：
10.1007/s00415-008-0837-3
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发表时间：
2008-07-01
影响因子：
6
通讯作者：
Baloh, Robert W.
中科院分区：
文献类型：
--
作者：
Cha, Yoon-Hee;Brodsky, Jae;Baloh, Robert W.
目的探讨Mal de debarquement（MdD）的临床特征和自然史。通过后续调查问卷和电话访谈设计回顾性案例审查。设置大学神经耳科诊所。患者 1980 年至 2006 年间就诊的患者，在进行被动运动后至少 3 天出现持续摇晃或摇晃的感觉。主要结果衡量临床特征、诊断测试和问卷反应。 2006 年，64 名患者（75% 为女性）确诊患有医学博士，其中 34 名患者完成了随访调查问卷和访谈。大多数患者的神经系统检查、ENG 和脑部 MRI 均正常。首次 MDD 发作的平均年龄为 39 +/- 13 岁。 64 名患者总共经历了 206 次发作。其中，104 次（51%）持续时间 > 1 个月； 18%，> 1 年； 15 > 2 年； 12 %，> 4 年，11 > 5 年。 18 名患者 (28%) 在首次 MDD 发作后随后出现了类似 MDD 症状的自发发作。继续发生自发发作的患者偏头痛发生率 (73%) 比没有发生自发发作的患者 (22%) 高得多。对于大多数多次发作的患者，随后的发作时间比之前的发作时间更长。重新进行被动运动可以暂时减轻大多数患者的症状（66%）。随着MDD的发作，对视觉运动的主观不耐受性增加（10%至66%），但自我运动敏感性却没有增加（37%至50%）。结论 大多数持续超过 3 天的 MDD 发作会在不到一年的时间内消退，但消退的可能性逐年下降。许多患者经历过多次MDD发作。一些患者在最初的运动触发发作后出现自发发作，偏头痛是一个危险因素。
Objective To investigate the clinical features and natural history of mal de debarquement (MdD). Design Retrospective case review with follow-up questionnaire and telephone interviews. Setting University Neurotology Clinic. Patients Patients seen between 1980 and 2006 who developed a persistent sensation of rocking or swaying for at least 3 days after exposure to passive motion. Main outcome measure Clinical features, diagnostic testing, and questionnaire responses. Results of 64 patients (75% women) identified with MdD, 34 completed follow-up questionnaires and interviews in 2006. Most patients had normal neurological exams, ENGs and brain MRIs. The average age of the first MdD episode was 39 +/- 13 years. A total of 206 episodes were experienced by 64 patients. Of these, 104 episodes (51 %) lasted > 1 month; 18 %, > 1 year; 15 > 2 years; 12 %, > 4 years, and 11 > 5 years. Eighteen patients (28 %) subsequently developed spontaneous episodes of MdD-like symptoms after the initial MdD episode. There was a much higher rate of migraine in patients who went on to develop spontaneous episodes (73 %) than in those who did not (22 %). Subsequent episodes were longer than earlier ones in most patients who had multiple episodes. Re-exposure to passive motion temporarily decreased symptoms in most patients (66 %). Subjective intolerance to visual motion increased (10 % to 66 %) but self-motion sensitivity did not (37 % to 50 %) with onset of MdD. Conclusion The majority of MdD episodes lasting longer than 3 days resolve in less than one year but the probability of resolution declines each year. Many patients experience multiple MdD episodes. Some patients develop spontaneous episodes after the initial motion-triggered episode with migraine being a risk factor.