Trigeminal Stimulation Elicits a Peripheral Vestibular Imbalance in Migraine Patients

Marano, E; Marcelli, Vincenzo; Stasio, Emilio Di; Bonuso, S; Vacca, Giovanni; Manganelli, Fiore; Marciano, Elio; Perretti, A.

doi:10.1111/j.1526-4610.2005.05069.x

Cited by 105 publications

(71 citation statements)

References 30 publications

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“…An interesting aspect is represented by the reciprocal connections between the vestibular and trigeminal-vascular pathways, thus producing a close association between vestibular and trigeminal information (22). Trigeminal stimuli may activate the vestibular system in patients with migraine but not in controls (36).…”

Section: Discussionmentioning

confidence: 99%

Otoneurologic Dysfunctions in Migraine Patients With or Without Vertigo

Casani¹,

Sellari–Franceschini²,

Napolitano³

et al. 2009

Otology &Amp; Neurotology

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Section: Discussionmentioning

confidence: 99%

Otoneurologic Dysfunctions in Migraine Patients With or Without Vertigo

Casani¹,

Sellari–Franceschini²,

Napolitano³

et al. 2009

Otology &Amp; Neurotology

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“…Alternatively, the central vestibular system could be involved in the migraine attack, during which there is activation of some brainstem nuclei [Weil ler et al, 1995] or a possible diffusion of spreading depression to them [Mraovitch et al, 1992]. Stimulation of the trigeminal nerve has been shown to provoke nystagmus in migraineurs [Marano et al, 2005]. The fact that no patients in this study experienced symptoms other than vertigo traditionally associated with basilar migraine, such as diplopia, hemifacial numbness or weakness, suggests that the vertigo may not necessarily be secondary to activating brainstem nuclei in all cases of vestibular migraine.…”

Section: Discussionmentioning

confidence: 99%

Nystagmus during Attacks of Vestibular Migraine: An Aid in Diagnosis

Polensek

Tusa²

2009

Audiol Neurotol

144

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Introduction: An estimated one-fourth to one-third of patients with migraine will experience vertigo associated with their migraine attacks. Vestibular migraine frequently presents as a diagnostic challenge as objective neurological findings consistent with this entity have not been well described. Objective: The aim of this study is to characterize eye movements of patients presenting with nystagmus during attacks of migrainous vertigo. Design: A retrospective study of 26 patients presenting with nystagmus during an acute vestibular migraine was performed. All patients were examined while symptomatic during a migraine spell, and also while asymptomatic. All patients underwent tests of vestibular function with either bithermal water caloric or rotary chair electronystagmography. Results: The most common patient was a female of perimenopausal age. Spontaneous nystagmus was seen in 19% of patients and nystagmus provoked by horizontal headshaking was seen in 35%. Nystagmus could be provoked with positional testing in 100% of symptomatic patients with fixation blocked. The positional nystagmus most commonly was sustained, of low velocity, and could be horizontal, vertical or torsional. Bithermal water caloric or rotary chair tests obtained during symptom-free intervals were normal in all patients. Conclusions: Although nystagmus characteristics are quite variable during vestibular migraine, the finding on examination of low-velocity, sustained nystagmus with positional testing in a young to middle-aged adult patient presenting with vertigo, nausea and headache is highly suggestive of vestibular migraine as long as the nystagmus dissipates when the patient is free of symptoms.

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“…Lesions associated with vestibular structures commonly produce nystagmus. Marano et al (2005) reported that spontaneous nystagmus developed more readily in migraine sufferers than in controls following unilateral electrical stimulation of the supraorbital region of the forehead, suggesting that trigeminal nerve activity evoked vestibular dysfunction in migraineurs.…”

Section: Vestibular Symptomsmentioning

confidence: 99%

Migraine and motion sickness: What is the link?

Cuomo-Granston

Drummond

2010

Progress in Neurobiology

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The brainstem is a structurally complex region, containing numerous ascending and descending fibres that converge on centres that regulate bodily functions essential to life. Afferent input from the cranial tissues and the special senses is processed, in part, in brainstem nuclei. In addition, brainstem centres modulate the flow of pain messages and other forms of sensory information to higher regions of the brain, and influence the general excitability of these cortical regions. Thus, disruptions in brainstem processing might evoke a complex range of unpleasant symptoms, vegetative changes and neurovascular disturbances and that, together, form attacks of migraine. Migraine is linked with various co-morbid conditions, the most prominent being motion sickness. Symptoms such as nausea, dizziness and headache are common to motion sickness and migraine; moreover, migraine sufferers have a heightened vulnerability to motion sickness. As both maladies involve reflexes that relay in the brainstem, symptoms may share the same neural circuitry. In consequence, subclinical interictal persistence of disturbances in these brainstem pathways could not only increase vulnerability to recurrent attacks of migraine but also increase susceptibility to motion sickness. Mechanisms that mediate symptoms of motion sickness and migraine are explored in this paper. The physiology of motion sickness and migraine is discussed, and neurotransmitters that may be involved in the manifestation of symptoms are reviewed. Recent findings have shed light on the relationship between migraine and motion sickness, and provide insights into the generation of migraine attacks.

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Trigeminal Stimulation Elicits a Peripheral Vestibular Imbalance in Migraine Patients

Cited by 105 publications

References 30 publications

Otoneurologic Dysfunctions in Migraine Patients With or Without Vertigo

Otoneurologic Dysfunctions in Migraine Patients With or Without Vertigo

Nystagmus during Attacks of Vestibular Migraine: An Aid in Diagnosis

Migraine and motion sickness: What is the link?

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