Vestibular migraine: diagnosis challenges and need for targeted treatment

Barbosa, Felipe de Galiza; Villa, Thaís Rodrigues

doi:10.1590/0004-282x20160037

Cited by 20 publications

(18 citation statements)

References 55 publications

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“…VM is a distinct clinical entity that accounts for a high proportion of vestibular symptoms.Diagnosis of VM mainly dependson recurrent vestibular symptoms, ahistory of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other reasons [2].And vestibular symptoms is based on the bárány society's classi cation of vestibular symptoms such as spontaneous vertigo, positional vertigo, visually-induced vertigo,head motion-induced vertigo and head motion-induced dizziness with nausea [15].In our studies, more than half of VM patientsare found spontaneous vertigo.10-20%VM patients have other forms of vertigo. We can nd thatthe most common vestibular symptom is spontaneous vertigo.Findings of most of studiesare similar our results [1,16,17]. Although most of VM patients have moderate to severevestibular symptoms.We still found some mild VM patients.…”

Section: Discussionsupporting

confidence: 88%

Assessment of Vestibular and Oculomotor Function in Patients with Vestibular Migraine: A Preliminary Study

Fu¹,

Han²,

He³

et al. 2020

Preprint

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Background: The purpose of the study is to assess the vestibular and oculomotor function in patients with vestibular migraine(VM).And we also investigate the relationship between test resultsandeffectiveness of prophylactic medication.Methods: We recruited 41 patientswith VM. They were examinedwith vestibular-evoked myogenic potentials(VEMP), video head impulse test(vHIT) and videonystagmography(VNG), including spontaneous or positional nystagmus, gaze-evoked nystagmus, smooth pursuit and caloric irrigation testing.All VM patients were treated withprophylactic medications. Theintensity of vertigo were evaluated with dizziness handicap inventory(DHI) before and after treatment. After 6 months, we evaluate the effectiveness of prophylactic medication. We analyzed the relationship between test resultsandeffectiveness of prophylactic medication.Results:In vestibular function test,71% of VM patients showed abnormal result. 20% showed abnormal air-conducted cVEMP and 42% showed abnormal air-conducted oVEMP. 32% showed abnormal vHIT and 56% showed abnormal caloric irrigation test.The abnormal rate of oVEMP was significantly higher than cVEMP (p<0.05). And the abnormal rate of caloric irrigation test was significantly higher than vHIT(p<0.05). In oculomotor function test, 42% showed pathological result. The abnormal rate of oculomotor function test was significantly lower than vestibular function test (p<0.05). After 6 months follow-up, rate of good effectiveness was significantly higher in normal vestibular function test group compared with the abnormal vestibular function test group (p<0.05). Rate of good effectiveness was no statistically significant difference between normal oculomotor function test group and abnormal oculomotor function test group (p>0.05).Conclusions: Abnormal vestibular and oculomotor function are commonly observed in VM patients. And VM patients with abnormal vestibular function have a weak effectiveness of prophylaxis medications.

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Section: Discussionsupporting

confidence: 88%

Assessment of Vestibular and Oculomotor Function in Patients with Vestibular Migraine: A Preliminary Study

Fu¹,

Han²,

He³

et al. 2020

Preprint

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“…The World Health Organization ranks migraine as the third most costly neurological disorder (1,2). Since there is no specific test to diagnose migraine, diagnosis is based on clinical history (3). This pain syndrome is associated with nausea and/or vomiting, photophobia and phonophobia (4).…”

Section: Introductionmentioning

confidence: 99%

Ghrelin attenuated hyperalgesia induced by chronic nitroglycerin: CGRP and TRPV1 as targets for migraine management

et al. 2017

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Background According to the neurovascular theory of migraine, activation of the trigeminovascular system contributes to the development of migraine. This study examined the effects of chronic intraperitoneal ghrelin (150 µg/kg) treatment on the development of chronic migraine induced by intermittent injection of nitroglycerin 10 mg/kg. Methods Baseline and post-drug (2 h following nitroglycerin injection) mechanical and thermal sensitivity were assessed by von Frey hair and tail immersion tests, respectively on days 1, 3, 5, 7, 9 and 11. Moreover, we investigated the effect of ghrelin treatment on nitroglycerin-induced aversive behavior by using a two-chamber conditioned place aversion paradigm. At the end of behavioral testing, on day 11, animals were sacrificed and plasma concentration of calcitonin gene-related peptide was measured using a rat-specific enzyme-linked immunosorbent assay kit. Also, real time polymerase chain reaction was used to quantify mRNA expression of calcitonin gene-related peptide and transient receptor potential vanilloid 1 in the trigeminal ganglion. Results Our results indicated that nitroglycerin activated the trigeminovascular system, which was reflected by mechanical and thermal hypersensitivity and elevation of mRNA expression of calcitonin gene-related peptide and transient receptor potential vanilloid-1, as migraine markers, and plasma calcitonin gene-related peptide levels. Moreover, chronic nitroglycerin injection induced conditioned place aversion and body weight loss. Nevertheless, ghrelin modulated nitroglycerin-triggered changes in transient receptor potential vanilloid-1 and calcitonin gene-related peptide expression, and mitigated nitroglycerin-induced hyperalgesia. Conclusion These results provide the first convincing evidence that ghrelin has a modulating effect on central sensitization induced by chronic intermittent nitroglycerin, and its antinociceptive effect may be related to a reduction of these factors in the trigeminal ganglion.

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“…During the acute attacks of vertigo, the analysis of the positional nystagmus usually permits differentiation of positional VM from benign paroxysmal vertigo. [13] TIA is considered more frequently in later ages. Ischemic attack is different to VM, with other accompanying neurological findings, risk factors, and a pathological doppler ultrasonography.…”

Section: Discussionmentioning

confidence: 99%

Vestibular Migraine: A case report and review of the literature

Say

Ergün

2018

Agri

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Vestibuler migren epizodik vertigonun en sık nedenlerinden biridir ancak başdönmesi yakınmalarına sahip olgularda vestibüler migren tanısı atlanabilmektedir. Bu yazıda epizodik vertigo atakları ve özgeçmişinde migrenöz başağrıları olan 46 yaşında kadın olguyu sunmayı amaçladık. Vertigo ataklarının bazılarına migrenöz vasıfta başağrısı eşlik ediyordu. Nörolojik değerlendirmesinde atak döneminde bakış ile indüklenen nistagmusu olup atak dışında normaldi. Kulak burun boğaz değerlendirmesi, laboratuar ve görüntüleme çalışmaları ile işitme testi normaldi. Klinik semptomatoloji temelinde vestibüler migren tanısı düşünüldü. Tedavide 500 mg valproik asit ile hızlı yanıt alındı.

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Vestibular migraine: diagnosis challenges and need for targeted treatment

Cited by 20 publications

References 55 publications

Assessment of Vestibular and Oculomotor Function in Patients with Vestibular Migraine: A Preliminary Study

Assessment of Vestibular and Oculomotor Function in Patients with Vestibular Migraine: A Preliminary Study

Ghrelin attenuated hyperalgesia induced by chronic nitroglycerin: CGRP and TRPV1 as targets for migraine management

Vestibular Migraine: A case report and review of the literature

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