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Sudden Onset of Vestibular Migraine Complicated with BPPV and Mal de Debarquement Syndrome – a Diagnostic Dilemma

https://doi.org/10.14412/2074-2711-2021-6-139-141

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Abstract

Vestibular migraine is combination of migraine and vestibular symptoms. In clinical examination it can be replaced with benign paroxysmal positional vertigo (BPPV) cupulolithiasis, but also BPPV is common comorbidity in migraine patients. There is also high association between vestibular migraine and Mal de Debarquement syndrome. Patient came to hospital with vertigo that was diagnosed as left PC-BPPV canalolithiasis. After first Epley's maneuver symptoms didn't resolved. Week after, at second Epley's maneuver performed patient developed left PC-BPPV cupulolithiasis. Month after, at third Epley's maneuver BPPV resolved but patient developed Mal de Debarquement syndrome. Laboratory testing showed hyperhomocisteinemia and homozygous MTHFR C677T and PAI, with low vitamin D. After reviewing the vestibular symptoms in the first attack which was misdiagnosed as BPPV canalolithiasis, and history of migraine, patient was diagnosed with vestibular migraine. Patient well responded to migraine diet and supplementation with B complex. Vestibular disorders are similar to each other and they can overlap. More attention in taking detailed medical history should be given to patients with vertigo or dizziness.

About the Authors

R. Perkoviс
Department of Neurology, J.J. Strossmayer University, Osijek University Hospital Centre
Croatia

 Trg Svetog Trojstva 3, 31000, Osijek, Croatia 



S. Maslovara
Department of Otorhinolaryngology, Vukovar County General Hospital; Department of Otorhinolaryngology and Maxillofacial Surgery, Medical Faculty, J.J. Strossmayer University
Croatia

 Zupanijska 35, 32000, Vukovar, Croatia 

 Trg Svetog Trojstva 3, 31000, Osijek, Croatia 



K. Kovaсeviс′ Stranski
Department of Rheumatology, Imunology and Allergology, J.J. Strossmayer University, Osijek University Hospital Centre
Croatia

 Trg Svetog Trojstva 3, 31000, Osijek, Croatia 



K. Buljan
Department of Neurology, J.J. Strossmayer University, Osijek University Hospital Centre
Croatia

 Trg Svetog Trojstva 3, 31000, Osijek, Croatia 



S. Tomiс′
Department of Neurology, J.J. Strossmayer University, Osijek University Hospital Centre
Croatia

 Trg Svetog Trojstva 3, 31000, Osijek, Croatia 



S. Juriс′
Department of Neurology, J.J. Strossmayer University, Osijek University Hospital Centre
Croatia

 Trg Svetog Trojstva 3, 31000, Osijek, Croatia 



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For citation:


Perkoviс R., Maslovara S., Kovaсeviс′ Stranski K., Buljan K., Tomiс′ S., Juriс′ S. Sudden Onset of Vestibular Migraine Complicated with BPPV and Mal de Debarquement Syndrome – a Diagnostic Dilemma. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(6):139-141. https://doi.org/10.14412/2074-2711-2021-6-139-141

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)