Migraine and episodic Vertigo: a cohort survey study of their relationship

Abstract

Background and aimMigraine headache and vestibular-type vertigo co-occur in the general population about three times more often than expected by chance. Attacks of episodic vertigo (eV) are currently not recognized as migraine equivalents or variants in the International Classification of Headache Disorders, 3rd edition (ICHD III). No strong data exist about the prevalence of eV during the phases of a migraine attack. The aim of this study is to analyze the timing association between migraine-related episodic vertigo and the phases of migraine.MethodsThe “Migraine and Neck Pain Study” gathered data from nearly 500 adult participants in a questionnaire-based survey. In this prospective, follow-up study we re-analyzed patients with episodic migraine with and without aura who experienced eV anytime around their migraine attacks. For this we defined 3 different time periods.Results146/487 (30%) reported eV anytime during the migraine attack; 79/487 (16%) that noticed eV with the start of the headache, 51/487 (10%) within 2 h before the headache and 16/487 (3%) experienced eV 2–48 h before the headache, as a premonitory symptom. 130/487 (26.7%) of our patients can be diagnosed with vestibular or probable vestibular migraine supporting the clinical association of migraine and vertigo.ConclusionsOur results seem to further support the concept that vertigo in migraine is best thought of as an integral manifestation of migraine, rather than a prodromal or aura symptom.

Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients – a cross sectional study

“…Our study suggests that migraineurs with vestibular symptoms exhibit similar postural control than migraineurs without self-report of vestibular symptoms. Additionally, we verified a high prevalence of the vestibular symptoms among the patients, which agrees with previous findings [1][2][3][4][5][6][7][8][9][10][11]. Based on the present and previous findings, we suggest that the vestibular symptoms and balance changes are a common condition among migraineurs and may be present on different severity levels according to the classic clinical presentation of migraine; and not due to a different classification considering only the presence of vestibular symptoms.…”

“…Migraineurs present a high prevalence of vestibular symptoms, such as dizziness and vertigo [1][2][3][4][5][6][7][8][9][10]. The cooccurrence of these symptoms with migraine is more frequent than expected by chance [10,11] during both the ictal and interictal period [6,9], and it can augment the impact on migraineurs' quality of life [1,4]. In that way, these symptoms can be considered as either part of the migraine presentation [11] or a different classificationas described in the Appendix of the International Classification of Headache Disorders (ICHD-III) as vestibular migraine [12], which was jointly formulated with the Committee for Classification of Vestibular Disorders of the Bárány Society [13].…”

“…The cooccurrence of these symptoms with migraine is more frequent than expected by chance [10,11] during both the ictal and interictal period [6,9], and it can augment the impact on migraineurs' quality of life [1,4]. In that way, these symptoms can be considered as either part of the migraine presentation [11] or a different classificationas described in the Appendix of the International Classification of Headache Disorders (ICHD-III) as vestibular migraine [12], which was jointly formulated with the Committee for Classification of Vestibular Disorders of the Bárány Society [13]. Patients with chronic migraine and migraine with aura present more prevalence of vestibular symptoms compared to migraineurs without aura [1][2][3][4][5][6]9].…”

Misperception of Visual Verticality in Patients with Primary Headache Disorders: A Systematic Review with Meta-Analysis

“…This link has been demonstrated in rats [ 68 ]. In addition, it has been suggested that an imbalance of the vestibular system may be induced by a painful trigeminal stimulation in migraine patients [ 18 ], and some authors have proposed that a vestibular disorder should be considered as an integral manifestation of headache and not as two different and concomitant diseases [ 69 ]. The function of the vestibular pathways is crucial in SVV perception.…”

Consideration of Migraines Among Risk Factors for Postoperative Nausea and Vomiting

“…The cortex and vomiting center in the brainstem are influenced by various extrinsic factors, including movement (via the vestibular system), drugs (such as opioids and anesthetics), activity in the area postrema, intestinal vagal afferent fiber activity and pain (in association with surgical manipulation of the gut), and emotions during the perioperative period (mediated by higher cortical centers) [ 34 ]. Migraine is associated with a wide range of psychiatric comorbidities, as well as various vestibular symptoms and vestibular syndromes [ 58 , 59 , 60 , 61 ]. The pain experienced by migraine sufferers, and the accompanying symptoms such as dizziness, vertigo, and anxiety, are likely to affect the development of PONV.…”