Circadian variations in occurrence and the clinical presentation of Vestibular Migraine: A retrospective study

Abstract

Background: As a new clinical disease entity, vestibular migraine (VM) is considered to be the commonest cause of spontaneous episodic vertigo. This study is trying to explore the circadian variations in occurrence and the clinical presentation of VM.Methods: We conducted a retrospective study and identified female patients who fulfilled the 2012 International Headache Society-Bárány Society Criteria for VM. Population’s clinical data were collected, including onset time and descriptions of sensations experienced by our patients during VM attacks.Results: A total of 189 female VM patients were included in our study. 74.0% of attacks in VM were presented in morning hours before 12 o’clock and the peak of occurrence was at about 7 o'clock. The attack frequency reached the baseline during 12:00-23:59 while there were two abnormal upward fluctuations at about 14:00 and 20:00. The biological circadian cycles may have greater impact of VM than lack of sleep. In addition, clinical presentations of vestibular symptoms including orthostatic vertigo, visually induced vertigo and dizziness showed variations among four 6-hour quadrants per day. Conclusions: Occurrence as well as clinical presentations of vestibular symptoms exhibited circadian variations among VM patients. These data suggested that chronobiological mechanisms may play a role in vestibular migraine pathophysiology.

Research progress in Chinese and Western medicine for vestibular migraine

“…Tang Yingchao [10] observed the clinical efficacy of nourishing blood and clearing the brain granules to prevent and treat vestibular migraine of blood deficiency and liver hyperactivity type. Liu Yin et al [11] used Chai Lian Ding Dazzling Granules to treat vestibular migraine with liver-stomach disharmony evidence with anxiety and depression state, and the results showed that it could effectively improve patients' vertigo symptoms and anxiety and depression. Wang Yang [12] used headache granules to conduct a clinical study on VM of the wind-yang upheaval type and found that the headache granules could reduce the patients' symptoms and improve their quality of life.…”