[investigation on the triggers and the effect of healthy education on recurrence of vestibular migraine].

Objective:The aim of this study is to investigate the predisposing factors and the effect of healthy education on recurrence of vestibular migraine (VM), so as to provide a scientific basis for increasing the knowledge rate and reducing the recurrence rate of VM patients. Method: Questionnaires, memory diary, regular follow-up, etc. were used to understand the possible predisposing factors of VM patients. Self-assessment depression scale (SDS) and self-assessment anxiety scale (SAS) were used to evaluate patients' mental and psychological status, and visual analogue scale (VAS) was used to evaluate the severity of vertigo. Health education was conducted for VM patients through face-to-face consultation, material distribution, modern multimedia and other methods. The knowledge rate, anxiety and fear psychological state, recurrence frequency of vertigo, duration and severity of vertigo were compared before and after the healthy education. Result:Of 103 cases of the object of study, 100 patients (97.1%) with different degree of sleep disorders, 96 cases (93.2%) had a clear family history with vertigo or dizziness headache, 90 cases (87.4%) had history of motion sickness, 90 cases (87.4%) had confined space history of intolerance, 82 cases (79.6%), recurrent cause psychological anxiety, fear, 80 cases (77.7%), lack of exercise, 79 cases (76.7%) under pressure from life or work, 53 (51.5%) had food preference, 8 cases (7.8%) think much rain attacks more frequent when humid climate,seven (6.8%) reported more episodes during the spring or spring/summer exchanges.After health education, patients were followed up for 6 months to 2 years with a median of 15 months, and their knowledge rate of VM was increased from 12.6% (13 cases) to 98% (101 cases).The psychological ratio of anxiety and fear decreased from 79.6% (82 cases) to 7.8% (8 cases).The SAS score decreased from 47.9±4.4 to 45.5±4.2, and the SDS score decreased from 39.7±3.6 to 38.2±3.8.The unhealthy lifestyle and eating habits （lack of exercise, stress, and eating preferences at least 1 item）decreased from 89.4% (92 cases) to 32.1% (33 cases).The recurrence rate of 83.5% (86 cases) of the patients was reduced by 1 time or more, and the rate of no recurrence increased from 1% (1 case) to 15.5% (16 cases) within half a year.The duration of the attack was reduced by 20% or more in 48.5%(50 cases),The mean duration of the attack declined from (17.4±1.4) hours before healthy education to (10.5±0.9) hours after healthy education.The VAS score of 86.4%(89 cases) with recurrence severity decreased by 2 points or more. The average VAS score before and after education was (6.6±0.1) points and (4.5±0.1) points respectively.The above differences were statistically significant (P<0.01) compared with those before and after education.
Conclusion: Sleep disorder, airtight space intolerance, excessive stress, lack of exercise, and dietary preference may be related factors to trigger VM attacks. Healthy education can significantly improve the awareness of VMs, and promote patients to change their lifestyle and eating habits. It can significantly improve patients' anxiety and fear psychological state, reduce the frequency of attack, shorten the duration of attack, and reduce the severity of selfassessment, which is worthy of clinical promotion. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.