Common Migraine and Vestibular Function

Abstract

Even though "classic migraine" and "complicated migraine" may be diagnosed readily, "common migraine" may be easily confused with other types of vascular headaches. This differential diagnosis is of great importance for the appropriate choice of drug therapy. It is frequently stated that family history of migraine and history of motion sickness in childhood suggest that a periodic vascular headache is most likely of migrainous origin; although this statement applies to ophthalmoplegic and hemiplegic migraine, it is doubtful that it applies to common migraine. In fact, in a pilot study of patients with common migraine, we have observed that family history and history of mo tion sickness in childhood did not contribute to the diagnosis. Vestibular dysfunctions are frequently associated with migraine including the common type. Utilizing labyrinthine tests with the aid of electronystagmography, abnormalities of labyrinth function were demonstrated in 80% of patients with common migraine who had no history of vertigo or of other otological and neurological disorders.

Vestibular migraine screening in a migraine‐diagnosed patient population, and assessment of vestibulocochlear function

“…In addition to the head impulse, many studies have investigated the presence of subclinical vestibular effects in migraine patients. Some of these studies concentrated on central, whereas others have concentrated on peripheral vestibular effect, but many of these studies reported the presence of both central and peripheral vestibular effects in the same patient population …”

Migrainous Vertigo: Clinical, Oculographic and Posturographic Findings

“…None of our patients with migraine not associated with vestibular symptoms had any finding indicating a peripheral or central dysfunction. In the study of Toglia (1), 80% of the migraine patients had a peripheral labyrinthine dysfunction. In Harno's series (10), 17% had unilateral hypoexcitability to caloric stimulation, but almost one‐third had inaccuracies in their saccadic eye movements indicating vestibulocerebellar dysfunction.…”

Vertigo and Dizziness Related to Migraine: A Diagnostic Challenge

“…About 10-20% of MV patients have unilateral hypoexcitability to caloric stimulation and about 10% have directional preponderance of nystagmus responses (17,21). Such findings, however, are not specific for MV, as they can be found also in migraine patients without vestibular symptoms (28) and in many other vestibular syndromes. Neuro-ophthalmological evaluation may reveal mild central oculomotor deficits in the absence of other brainstem or cerebellar signs (21).…”