Temporal Patterns of Vertigo and Migraine in Vestibular Migraine

Abstract

Vestibular migraine (VM) is a multidisciplinary disease under exploration. Multiple temporal patterns of vertigo and migraine make it difficult to diagnose VM, and their effect on the clinical features of VM is still unclear. Here we investigated the clinical features of VM under three temporal patterns. 172 VM patients were enrolled in this study and divided into three groups: 86 patients in group A had an earlier onset of migraine than vertigo, 35 patients in group B had an earlier onset of vertigo than migraine, and 51 patients in group C had concurrent vertigo and migraine. No significant difference was found among three groups regarding types, intensity and accompanying symptoms of the vestibular attack. Patients in group C presented higher frequency and longer duration of vertigo than group A and B, while patients in group A presented lower frequency and shorter duration of headaches than group B and C. Additionally, the frequency, duration, intensity and accompanying symptoms of headache in group A decreased significantly after the onset of vertigo, especially in women around menopause. We hypothesized that vestibular stimulation could inhibit the trigeminal pain pathway, while painful trigeminal stimulation could excite the vestibular system. Our findings may contribute to the clinical identification of VM and further clarification of its pathogenesis.

Circadian variations in occurrence and the clinical presentation of Vestibular Migraine: A retrospective study

“…Orthostatic vertigo was reported more frequent in the morning hours while dizziness was reported more frequent in the afternoon hours. Headaches may or may not accompany vestibular symptoms during VM attacks, consistent with previous study (5). The majority reported nausea with or without vomiting, photophobia or phonophobia.…”

“…As the most common neurologic cause of episodic vertigo, vestibular migraine (VM) is a variant of migraine resulting in vestibular symptoms in addition to migraine (1,2). Despite a prevalence of between 1% and 2.7% of adult population(3), diagnosis of VM is challenging perhaps due to the broad spectrum of its manifestations, complex temporal patterns and its very recent nosological de nition (4,5). Several biological phenomena and diseases have speci c circadian rhythms (6)(7)(8).…”

Vestibular Migraine and Tinnitus: A Challenging Narrative

“…Higher rates of VM were reported among females with an estimated prevalence of 64.7-84.9% [7][8][9][10][11][12][13]. Women in their sixth decade (mean: 50.5 years; range: 24-76) were more likely to report episodes of VM with concomitant tinnitus during and after vertigo attacks compared to males [4][5][6][7][8][9][10][11][12]. No previous noise exposure, surgical intervention, or acoustic trauma was reported in the selected studies [4][5][6][7][8][9][10][11][12][13].…”

“…In the 10 studies (seven cross-sectional studies and three retrospective chart reviews), 951 patients with the diagnosis of VM not associated with other vestibular disorders reported tinnitus (Table 2). The estimated prevalence among the selected studies was 39.6% (range: 7-52.56%) [4][5][6][7][8][9][10][11][12][13]. According to one cross-sectional study, the average age for tinnitus presentation in VM patients was 38.6 years.…”

Severity and Its Contributing Factors in Patients With Vestibular Migraine: A Cohort Study

“…We enrolled patients with probable VM, who might develop definite VM over time as some studies have shown ( 33 – 35 ). Moreover, we did not assess headache and vestibular symptoms separately, considering the complex temporal patterns between them ( 36 ). The exact clinical relevance needs to be further studied.…”