Perbedaan Gejala Vestibular pada Pasien Migrain Tanpa Aura dan Migrain Kronik Terhadap Tingkat Disabilitas

Abstract

Background: Headache and the presence of vestibular symptoms are commonly associated in the clinical practice. The understanding of the relationship between migraine and vestibular symptoms is considered a challenging issue, since vestibular symptoms can manifest as an inherent migraine feature. This study aims to examine the effect of vestibular symptoms in migraine patients without aura and chronic migraine on disability rates. Methods: This cross-sectional study was conducted on 50 people diagnosed with migraine without aura (25 people) and chronic migraine (25 people) based on Konsensus Nasional V Kelompok Studi Nyeri Kepala Perhimpunan Dokter Spesialis Saraf Indonesia (PERDOSSI) 2018. Self-perceived disability associated with vestibular symptoms was assessed using the Dizziness Handicap Inventory questionnaire. Statistical analysis with Chi Square Test, Independent T Test and Mann Whitney Test. Results: 62% of patients, the majority of women in migraine without aura and chronic migraine, have vestibular symptoms. There were more differences in vestibular dizziness and postural symptoms of chronic migraine patients compared with migraine without aura to DHI with p = 0.000 and p = 0.0025. There were significant differences in vestibular vertigo, dizziness, and postural symptoms in the chronic migraine group with migraine without aura on emotional aspects with p = 0.000; p = 0.000 and p = 0.02. There were significant differences in vestibular vertigo, dizziness, and postural symptoms in the chronic migraine group with migraine without aura on physical aspects with p = 0.029; p = 0.000 and p = 0.002. There were significant differences in vestibular vertigo, dizziness, and postural symptoms in the chronic migraine group with migraine without aura on functional aspects with p = 0.005; p = 0.003 and p = 0.005. Conclusion: There was a significant difference between vestibular symptoms in migraine without aura and chronic migraine on the level and aspect of disability.

Latar Belakang: Nyeri kepala dan gejala vestibular umum terkait dalam praktik klinis. Pemahaman tentang hubungan antara migrain dan gejala vestibular dianggap sebagai masalah yang menantang, karena gejala vestibular dapat bermanifestasi sebagai fitur migrain yang melekat.Penelitian ini bertujuan untuk mengetahui perbedaan gejala vestibular pada pasien migrain tanpa aura dan migrain kronik terhadap tingkat disabilitas. Metode: Penelitian potong lintang yang dilakukan pada 50 orang yang didiagnosa migrain tanpa aura (25 orang) dan migrain kronik (25 orang) berdasarkan kriteria diagnostik pada Konsensus Nasional V Kelompok Studi Nyeri Kepala Perhimpunan Dokter Spesialis Saraf Indonesia (PERDOSSI) tahun 2018. Kecacatan yang dipersepsikan sendiri terkait dengan gejala vestibular dinilai melalui kuesioner Dizziness Handicap Inventory. Analisa statistik dengan Uji Chi Square, Uji T Independent dan uji Mann Whitney. Hasil: 62% pasien mayoritas perempuan pada migrain tanpa aura dan migrain kronik yang memiliki gejala vestibular. Terdapat perbedaan gejala vestibular dizziness dan postural pasien migrain kronik lebih banyak dibandingkan dengan migrain tanpa aura terhadap DHI dengn p=0,000 dan p=0,0025. Terdapat perbedaan gejala vestibular vertigo, dizziness, dan postural yang signifikan pada kelompok Migrain kronik dengan migrain tanpa aura terhadap aspek emosional dengan p=0,000; p=0,000 dan p=0,02. Terdapat perbedaan gejala vestibular vertigo, dizziness, dan postural yang signifikan pada kelompok Migrain kronik dengan migrain tanpa aura terhadap aspek fisik dengan p=0,029; p=0,000 dan p=0,002. Terdapat perbedaan gejala vestibular vertigo, dizziness, dan postural yang signifikan pada kelompok Migrain kronik dengan migrain tanpa aura terhadap aspek fungsional dengan p=0,005; p=0,003 dan p=0,005. Kesimpulan: Dijumpai perbedaan yang signifikan antara gejala vestibular pada pasien migrain tanpa aura dan migrain kronik terhadap tingkat dan aspek disabilitas.