Migraine is associated with an increased risk for benign paroxysmal positional vertigo: a nationwide population-based study

Abstract

BackgroundThere is evidence suggesting that migraine may be associated with vertigo. The aim of this study was to assess the risk of benign paroxysmal positional vertigo (BPPV), the most common form of vertigo, in patients with migraine using a population-based dataset.MethodsThe National Health Insurance Research Database in Taiwan was searched for migraine patients and was also used to select an age- and sex-matched cohort of subjects without migraine. The analyses included 8266 migraine patients and 8266 controls. The incidence rates of BPPV in the two cohorts were compared. Cox proportional hazard models were used to identify risk factors for BPPV in migraine patients.ResultsIn the migraine cohort, 1.11 % of the patients developed BPPV compared to 0.5 % of the controls. The incidence rate ratio was 2.03 (95 % CI 1.41–2.97; p <0.001). Cox proportional hazards analysis showed that age ≥40 years (HR 2.20; 95 % CI 1.40–3.45; p = 0.001), coronary artery disease (HR 4.62; 95 % CI 1.12–19.01; p = 0.034), and the number of outpatient department visits to neurologists because of migraine (HR 2.93; 95 % CI 2.50–3.44; p >0.001) were associated with an increased risk for BPPV.ConclusionThe results showed that patients with migraine had a 2.03-fold increased risk of developing BPPV compared with age- and sex-matched controls. Although BPPV may not be a common condition in migraine patients, migraine sufferers with vestibular symptoms should alert physicians to the possibility of BPPV, particularly if patients are aged ≥40 years, have a history of coronary artery disease, or have frequent visits to neurologists clinics because of migraine.

Review of the pathology underlying benign paroxysmal positional vertigo

“…Previous studies have shown that patients with migraine seem more likely to develop BPPV than subjects in the control group. [7][8][9] Kim et al 10 performed a nationwide cohort study and reported a higher incidence of BPPV in patients with migraine (6.0%) than in control subjects (3.2%). Faralli et al 11 reviewed the recovery time, residual dizziness, and recurrence in patients with BPPV with and without migraine.…”

Neuro-otology- some recent clinical advances

“…Also, patients can have headache with their BPV [83] and those who have migraine are more likely to have BPV than those who do not [84]; those who have idiopathic BPV are more likely also to have migraine than those who have post-traumatic BPV [85]. …”

Subclinical vestibular dysfunction in migraineurs without vertigo: A Clinical study

“…27 mostly if migraineurs aged ≥40 years(HR = 2.20). 28 Moreover, compared to Meniere's disease group, patients with benign recurrent vertigo (BRV) had a female preponderance, earlier age of onset, and increased incidence of migraine (OR = 0.3). 29 These findings were confirmed by Porta-Etessam and coll., assuming that migraine associated recurrent vertigo (MARV) and the possible vestibular hypofunction of migraine patients are symptoms that share physiological aspects with migraine.…”