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Yıl:2018; Cilt: 55; Sayı: 1>> Özet
TAM METİN
Nöropsikiyatri Arşivi; 2018;55(1):9-14
Vestibüler Migren Hastalarında Dizabilite Seviyelerine Göre Denge ve Bilişsel İşlevlerin İncelenmesi
B Balcı, N Şenyuva
Dokuz Eylül Üniversitesi, İzmir
Amaç: Vestibüler migren (VM) hastalarında denge ve bilişsel düzeyin baş dönmesi olmayan migrenliler ve sağlıklı bireyler ile karşılaştırılması, dizabilite seviyesinin bu işlevler üzerine etkisinin incelenmesidir. Yöntem: Çalışmaya VM tanısı alan 32 hasta ile benzer yaş-cinsiyette 32 migren hastası ve 31 sağlıklı birey katıldı. Denge değerlendirmesi Denge Değerlendirme Sistemleri Testi (DDST) ile, baş dönmesi ve baş ağrısı şiddeti Vizüel Analog Skala (VAS) ile, baş dönmesine bağlı dizabilite seviyesi Baş dönmesi Engellilik Envanteri (BEE) ile, bilişsel işlevler Stroop testi ile değerlendirildi. Bulgular: Hasta ve kontrol grupları arasında yaş, cinsiyet, boy, vücut ağırlığı, medeni durum ve eğitim düzeyi açısından anlamlı fark bulunmadı (p>0,05). Baş ağrısı şiddeti migrenlilerde VM hastaları ve sağlıklı bireylerden, baş dönmesi şiddeti VM grubunda migrenliler ve sağlıklılardan anlamlı olarak daha yüksekti (p0,0167). VM hastalarında Stroop etkisi ile DDST-T arasında negatif korelasyon (r=-0,509, p=0,003) olduğu, migrenlilerde ise bilişsel işlevler ile denge işlevleri arasında anlamlı ilişki tespit edilmemiştir (p>0,05). Hastalık dizabilite düzeyini yansıtan BEE sonuçlarına göre; VM hastalarının dizabilite şiddetinin %38,7’sinde hafif, %51,6’sı orta, %9,7’si şiddetli olduğu tespit edilmiştir. VM hastalarında denge ve bilişsel işlevler açısından dizabilite grupları arasında anlamlı fark görülmedi (p>0,05). Sonuç: VM hastalarında ve migrenlilerde hem denge hem de bilişsel performansın sağlıklı bireylerden daha kötü olduğu, fakat hastaların vertijinöz yakınmalar açısından birbirleriyle farklılılık gösterdiği, bilişsel süreçler açısından ise farklılık göstermediği tespit edildi. Hastalarda yapılacak boylamsal değerlendirmeler ile fonksiyonel kısıtlılıkları çözmek tedavide kolaylaştırıcı olabilir. Ortaya çıkan bu farklı sorunlara yönelik uygun fizyoterapi programı ve hasta eğitimleri planlanabilir.
Definition of Balance and Cognition Related to Disability Levels in Vestibular Migraine Patients
Objective: To compare the balance and cognition of vestibular migraine (VM) patients with migraineurs without vertigo history and healthy subjects, and to examine the effects of disability level on these functions. Material-method: The study consisted of 32 VM patients, 32 migraineurs and 31 healthy subjects with similar sex and age. Balance functions were assessed with Balance Evaluation Systems Test (BEST), dizziness and headache severity with Visual Analogue Scale (VAS), disability related to dizziness with Dizziness Handicap Inventory (DHI), cognition with Stroop test. Results: There was no statistical significant difference among the three groups in terms of age, gender, height, weight, marital status and education levels (p>0.05). Headache severity was higher in migraineurs than vestibular migraineurs and healthy subjects, also dizziness severity was higher in vestibular migraineurs than migraineurs and healthy subjects (p0.0167). There was a negative correlation between Stroop effect and BEST-total in VM patients significantly (r=-0.509, p=0.003), and no significant correlation in migraineurs (p>0.05). Disability levels of VM patients were low in 38.7%, mild in 51.6% and severe in 9.7% related to DHI. There was no significant difference between balance and cognition function in terms of disability levels (p>0.05). Conclusion: The balance and cognition in VM patients and migraineurs were impaired rather than healthy subjects. The patient groups differed from each other in terms of vertiginous complaints rather than cognition. Solving the functional limitations with further longitudinal examinations can facilitate the treatment. The appropriate physiotherapy programs and patient education methods can be planned for these various issues.

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