Unilateral Head Impulses Training in Uncompensated Vestibular Hypofunction

Table 1

Evolution of the symptoms, diagnosis, and treatment.

June 2011	2011–2014	July 2014	August 2014	November 2016
Initial symptoms	Evolution	Before treatment with unilateral head impulses	After treatment with unilateral head impulses	Phone communication
Sudden rotational vertigo lasting more than 48 hours, intense autonomic symptoms	Beginning of menses migraine	Migraine, less intensity and frequency	Premenstrual migraine	Sporadic migraine
Unsteadiness +++	Unsteadiness ++	Unsteadiness ++	Unsteadiness +	Unsteadiness +
Nausea and vomiting	Blurred vision with head movements +++	Blurred vision with head movements +++	Blurred vision with head movements +	Blurred vision with head movements ++
		DVA 6 lines (abnormal)	DVA 2 lines (normal)
	DHI: 66	DHI: 34	DHI: 12
	Dizziness ++	Dizziness ++	Dizziness +	Dizziness +
	Dizziness in darkness ++	Dizziness in darkness ++	Dizziness in darkness +	Dizziness in darkness ++
Unilateral weakness right ear 78% (VNG)		Unilateral weakness right ear 80% (VNG)
Diagnosis: vestibular neuritis	Diagnosis: right vestibular hypofunction without compensation. Premenstrual migraine	Diagnosis: right vestibular hypofunction without compensation. Premenstrual migraine	Diagnosis: right vestibular hypofunction with compensation. Premenstrual migraine	Diagnosis: premenstrual migraine. The patient should do new clinical and lab evaluation
Vestibular rehabilitation	Vestibular rehabilitation and migraine prophylaxis	Betahistine plus unilateral head impulses	No treatment	Waiting for new evaluation

+++: severe; ++: moderate; +: mild; DVA: dynamic visual acuity; VNG: videonystagmography; DHI: Dizziness Handicap Inventory.