Migrainous Vertigo: Clinical, Oculographic and Posturographic Findings

Abstract

Migrainous vertigo (MV) is accepted as a common cause of episodic vertigo. The peripheral or central vestibular localization of the deficit as well as the pathophysiology is unclear. This prospective study was designed to assess the clinical features of MV and to search for the localization of the vestibular pathology. Thirty-five patients with MV, 20 patients with migraine and 20 healthy volunteers were studied. Comprehensive neurotological tests were performed between attacks. None of the normal controls or the patients with migraine had ocular motor deficits or caloric test abnormalities. Three patients in the MV group showed saccadic pursuit (8.6%), in one of whom saccadic hypometria was also present. Caloric test results revealed unilateral caloric hypofunction in seven patients (20%). Static posturography results revealed increased sway velocity when the eyes were closed or the platform was distorted in patients with MV. These findings during the symptom-free period revealed that peripheral vestibular dysfunction was more common than a central deficit.

Perception of Verticality in Patients with Primary Headache Disorders

“…On the other hand, 5 of the 24 VM patients (20.8%) showed unilateral caloric paresis or paralysis consistent with the previous results [5,7,15] . None of the patient groups showed any cVEMP abnormality.…”

“…Vestibular dysfunction beginning from the labyrinth to the cerebral cortex due to migraine mechanisms has been proposed as an explanation [7,8] . Migraine patients with vertigo have been reported to have a 20%-25% prevalence of caloric hypofunction, indicating involvement of the horizontal semicircular canals [5,7,15] . cVEMP abnormalities, including absent or delayed cVEMPs [16,17] or cVEMPs of normal latency but reduced amplitude, have been reported in different studies [18] , which were proposed to indicate lesions of the sacculocollic pathways in the brainstem or saccular damage.…”

“…The pathogenesis is uncertain, but migraine mechanisms may interfere with the vestibular system at the labyrinth, brainstem, and cerebral cortex [7,8] . Inevitably, several studies have been performed to assess vestibulo-ocular, vestibulo-collic, and vestibulospinal functions in patients with migraine by using caloric tests, cervical vestibular evoked myogenic potentials (cVEMPs), and posturography, with results indicating peripheral, central, or combined vestibular deficits [5,7,[12][13][14][15][16][17][18][19][20] . Motion detection thresholds have also been studied [21] .…”

Migraine-associated vertigo and dizziness as presenting complaint in a private general medical practice

“…9 It is an interesting fact that most studies on MV show a clear female predominance that also correlates with the predominance of migraine in the female population. 1,9,10 There are studies linking an increased risk of stroke in females in their thirties that suffer from migraine with aura and use the oral contraceptive pill (OCP). 11 For this reason use of the OCP is contraindicated in women suffering from migraine with aura.…”

Current drug treatments for vestibular disorders

“…Такие приступы могут про-должаться от нескольких минут до нескольких часов, реже -более суток. В период приступа головокружения могут воз-никать спонтанный нистагм, фото-и фонофобия [28][29][30][31]. Вопрос о нозологической самостоятельности мигрень-ассо-циированного головокружения остается открытым, однако тесная связь между теми или иными проявлениями вестибу-лярной дисфункции и мигренью не вызывает сомнений.…”