Presence of vestibular symptoms and related disability in migraine with and without aura and chronic migraine

Abstract

Objective To assess the presence and handicap due to vestibular symptoms in three subgroups of patients with migraine and controls. Methods Women between 18-55 years old were diagnosed by headache specialists and stratified as migraine with aura (n = 60), migraine without aura (n = 60), chronic migraine (n = 60) and controls (n = 60). Information regarding demographics, headache and vestibular symptoms were collected in this cross-sectional study. The self-perceived handicap related to vestibular symptoms was assessed through the Dizziness Handicap Inventory questionnaire. Results A total of 85% of women with migraine with aura and chronic migraine had vestibular symptoms contrasted to 70% of the migraine without aura group ( p < 0.05), and 12% of the control group reported symptoms ( p < 0.0001). Patients with migraine exhibited greater Dizziness Handicap Inventory scores than controls ( p < 0.001); and migraine with aura and chronic migraine groups reached greater scores than migraine without aura ( p < 0.01). Presence of migraine is associated with a greater risk of vestibular symptoms (migraine without aura: 5.20, migraine with aura: 6.60, chronic migraine:6.20, p < 0.0003) and with a greater risk of moderate-to-severe handicap (migraine without aura: 20.0, migraine with aura: 40.0, chronic migraine: 40.0, p < 0.0003). The presence of aura and greater migraine frequency adds to the risk of any handicap (migraine with aura: 1.9, chronic migraine: 1.7, p < 0.04) and to the risk of moderate-to-severe handicap (migraine with aura: 2.0, chronic migraine: 2.0, p < 0.0003). Migraine aura, intensity and frequency predict 36% of the dizziness handicap. Conclusion The prevalence of vestibular symptoms is increased in migraine during and between headache attacks, particularly in migraine with aura and chronic migraine along with an increased handicap due to those symptoms. Vestibular symptoms among subgroups of migraine should be considered when evaluating the functional impact of migraine.

Presence and Clinical Value of Vestibular Symptoms in Migraine

“…Even after this exclusion, the results still show that there is an association between migraine and vestibular symptoms, which is more common in patients with chronic headache; this nding is consistent with the results of previous studies (8,9). However, the chronicity of migraine was not accounted for in the proposed vestibular migraine criteria (7,9), and it is poorly explored by studies on the topic (9,21,22). The correlation between vestibular symptoms and headache needs to be further researched.…”

“…The association between vestibular symptoms and migraine has been established in previous studies (9,14,15), which led the International Headache Society and the International Vertigo Society to propose research criteria for vestibular migraine (16). Our previous studies showed that 10% of migraine patients ful lled the research criteria for vestibular migraine (11,17).…”

“…The relationship between vestibular symptoms and migraine is complex and extends, far beyond the diagnosis of vestibular migraine (8,9). At present, there are few studies on migraine with dizziness or vertigo as related symptoms, and there are few reports on the temporal relationship between migraine and vestibular symptoms; such a temporal relationship is likely to affect the mechanistic study of the correlation between vestibular symptoms and migraine.…”

Vestibular Migraine I: Mechanisms, Diagnosis, and Clinical Features

“…29,30 When vestibular symptoms were assessed in patients with migraine using the Dizziness Handicap Inventory Questionnaire, more than two-thirds reported vestibular symptoms, compared with 12% in controls. 31 Patients with MA and chronic migraine were significantly more likely to have vestibular symptoms than patients with migraine without aura (MoA). Vestibular symptoms can occur during headaches, but often occur during headache-free intervals.…”

The Bucket Test Differentiates Patients with MRI Confirmed Brainstem/Cerebellar Lesions from Patients Having Migraine and Dizziness Alone

“…In addition, duration of VM episodes are notoriously variable, where intense episodes may occur on the order of minutes to hours to days [9], or as constant and lingering symptoms of less intensity but lasting months or years [16]. Recently, emerging evidence confirms vestibular symptoms from vestibular migraine can to be chronic [17]. The initial episodes of VM can be frighteningly similar with the acute vestibular syndrome or an acute but transient vestibular syndrome (<24 hours).…”