A Chameleon Among the Episodic Vertigo Syndromes: ‘Migrainous Vertigo’ or ‘Vestibular Migraine’

Brandt, Thomas

doi:10.1111/j.1468-2982.2004.00663.x

Cited by 37 publications

(27 citation statements)

References 18 publications

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“…Hence, vestibular migraine has even been considered a chameleon [4] among the episodic vertigo syndromes. One explanation for the heterogeneity of the various vestibular tests might be due to different vulnerability of the labyrinthine structures for ischemia or for serotonergic induced extravasation, indicating that the saccule is more vulnerable than other inner ear structures.…”

Section: Discussionmentioning

confidence: 99%

“…This form of migraine is characterized by the key symptom of vertigo [10,15,44], but it can mimic other vestibular disorders, e.g., attacks of Menière's disease [4]. Thus, for differential diagnosis, VEMPs may prove valuable, since vestibular migraine is a common diagnosis accounting for 6-9% of the various vertigo syndromes in dizziness units [15,34,39].…”

Section: Introductionmentioning

confidence: 98%

“…So far there has been no study on VEMPs in patients with so-called ''vestibular migraine'' [4,15,33,34]. This form of migraine is characterized by the key symptom of vertigo [10,15,44], but it can mimic other vestibular disorders, e.g., attacks of Menière's disease [4].…”

Section: Introductionmentioning

confidence: 99%

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Vestibular-evoked myogenic potentials in vestibular migraine

2009

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Sound-induced vestibular-evoked myogenic potentials (VEMPs) can be used to investigate saccular function, measured from the tonically contracted sternocleidomastoid muscles (SCM) in response to loud sound stimuli. The aim of the present study was to assess VEMPs in patients with vestibular migraine and to determine whether saccular function is affected by the disease. Furthermore, tests such as tilts of subjective visual vertical (SVV) and caloric testing were conducted to test whether deficits in the various tests are associated with each other. The amplitude and latency of VEMPs were measured from the SCM in 63 patients with vestibular migraine (median age 47 years; range 24-70 years) and compared with those of 63 sex- and age-matched healthy controls (median age 46 years; range 17-73 years). Of the 63 patients with vestibular migraine, 43 (68%) had reduced EMG-corrected VEMP amplitudes compared to the controls. Thus, the mean of the p13-n23 amplitudes of the vestibular migraine patients were 1.22 (SE +/-0.09) for the right and 1.21 (SE +/-0.09) for the left side, whereas the averaged amplitudes of the 63 healthy controls showed a mean of 1.79 (SE +/-0.09) on the right and of 1.76 (SE +/-0.09) on the left. No difference was seen in the latencies and there was no correlation between VEMP amplitudes, tilts of SVV and caloric testing. Our data on patients with vestibular migraine indicate that the VEMP amplitudes are significantly and bilaterally reduced compared to those of controls. This electrophysiological finding suggests that both peripheral vestibular structures, such as the saccule, but also central vestibular structures are affected. Thus, beside the brainstem, structures in the inner ear also seem to contribute to vertigo in vestibular migraine.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Vestibular-evoked myogenic potentials in vestibular migraine

2009

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“…Such monosymptomatic forms of migraine with vertigo as the main symptom have been referred to as "vestibular migraine" [3][4][5], "migrainous vertigo" [1,6], or "migraine-associated vertigo" [7]. This form of migraine can be considered a "chameleon" among the episodic vertigo syndromes, since it can mimic various disorders such as transient ischemic attacks, vestibular paroxysmia or Menière's disease [4,5]. Thus, the symptoms associated with "vestibular migraine" and their clinical presentation vary [1,3].…”

Section: Introductionmentioning

confidence: 99%

“Vestibular migraine”: effects of prophylactic therapy with various drugs

2009

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Vertigo is frequently associated with migraine, and sometimes it is the cardinal symptom. This type of migraine is called "vestibular migraine", "migrainous vertigo", or "migraine-associated vertigo". Earlier findings on effective prophylactic medication for such migraine attacks and their clinical features are few and insufficient. Our aim was to study the influence of prophylactic therapy on this type of migraine and to specify its clinical features. In a retrospective approach 100 patients (median age 47 years, range 21-72 years) with definite or probable vestibular migraine were divided into two groups: those with (74 patients) and those without drug prophylaxis (26 patients). They were then interviewed by telephone at least 6 months after beginning therapy. All patients receiving medical prophylaxis showed a decrease of duration, intensity, and frequency of episodic vertigo as well as nearly all its associated features (p < 0.01). The group without medical prophylactic therapy showed only a reduction of vertigo intensity. Only 39 % of the 100 patients met the current IHS criteria for a basilar-type migraine. Thus, we propose that a new category--"vestibular migraine"--should be added to the HIS criteria. Furthermore, our data show that prophylactic medication may be effective for treating vestibular migraine and its associated symptoms; therefore, patient's response to medical therapy may provide guidance in the diagnostic process of vestibular migraine.

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“…This proportion is higher than the prevalence of 6-9 per cent reported in selected patient groups in other countries. 4,5,12 As noted above, previous Thai series have not reported vestibular migraine (K Y K Bangpoophamorn and S Sirompotong, unpublished data). [1][2][3] There could be a number of reasons for this.…”

Section: Discussionmentioning

confidence: 85%