Frequency of Migraine as a Chief Complaint in Otolaryngology Outpatient Practice

Abstract

Objective. To identify the frequency of typical (headache and dizziness) and common atypical (ear fullness, pressure, pain, tinnitus, facial fullness, and nasal congestion) migraine symptoms as chief complaints among patients presenting to otolaryngology clinic. Methods. This is a descriptive study of prospectively collected data from a general otolaryngology practice. Typical migraine presentations were diagnosed by applying international headache society (IHS) criteria for migraine headache and Neuhauser's criteria for migrainous vertigo. Atypical otologic and rhinologic migraine symptoms were diagnosed using individualized criteria. Charts were reviewed at 6-month interval from the first presentation. Results. Out of 1002 consecutive patients, 10.8% presented with “migrainous chief complaint.” All migrainous chief complaint patients had a history of headache but not all of them presented with headache. Corrected female to male ratio in the migraine group was 3 to 1; age distributions were significantly different between the migraine and nonmigraine groups by applying t-test. Out of the atypical complaints, 86% of the patients had a history of concomitant typical presentation. Conclusion. Actual diagnostic criteria for migraine do not satisfy the diversity of its presentation. Investigating the history of migraine is enough to diagnose most atypical presentations. Sound knowledge about migraine seems essential for any ENT practitioner.

Vestibular migraine in multicenter neurology clinics according to the appendix criteria in the third beta edition of the International Classification of Headache Disorders

“…The prevalence of VM in previous studies was dependent on different diagnostic criteria and study populations. Prior to the current diagnostic criteria, the prevalence of VM was 9%-11.9% in headache clinics, 4.7%-29.3% in otolaryngology clinics, and 6%-25.1% in specialized dizziness clinics (4,11,14,19,20,23). Only one study assessed the prevalence of VM based on the consensus criteria formulated by the Barany Society and the IHS; 4.2% were assigned to the definite VM group and 5.7% to the probable VM group in a tertiary referral otolaryngology clinic (12).…”

Turbinate Submucosal Reduction Operation Reduced Migraine Admission among Patients with Chronic Hypertrophic Rhinitis

“…Approximately 10.8% of patients had a migrainous chief complaint in otolaryngology outpatient practice [16]. Almost 90% of sinus headache patients were determined to have migraine.…”

Vestibular Migraine: Clinical Challenges and Opportunities for Multidisciplinarity

“…Vertigo can arise in the context of a headache attack (preceding, occurring with, or after) [17] or between attacks, and the temporal relationship is extremely varied [3]. Vertigo episodes have a variable duration from clusters of seconds (10%), occurring repeatedly for a period of time, to attacks during minutes (3%) [38], days (30%), and rarely weeks [2, 39]. By definition, they last from minutes to hours or days (usually, less than 72 h), with the sum of the clusters being considered as one attack.…”

“…Studies in tertiary headache clinics reveal great variability in prevalence in different series and according to the clinical context: 4.7–29.3% in an otolaryngology clinic and 9–11.9% in a headache clinic [7, 17, 26, 38]. A recently retrospective, observational, and descriptive study [40] performed in an outpatient clinic revealed that VM affects more middle-aged women than men and that migraine was diagnosed before vertigo in the majority of the situations [40].…”