Vestibular migraine: the most frequent entity of episodic vertigo

Dieterich, Marianne; Obermann, Mark; Çelebisoy, Neşe

doi:10.1007/s00415-015-7905-2

Cited by 221 publications

(198 citation statements)

References 85 publications

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“…It has lifetime prevalence of VM which was about 1% and 1-year prevalence of 0.9% in the general population [20]. Therefore, VM may be the most common cause of recurrent spontaneous vertigo attacks after benign paroxysmal positional vertigo (BPPV) [21]. Despite the relatively high prevalence of VM, it remains underdiagnosed.…”

Section: Epidemiology Of Vmmentioning

confidence: 99%

Recent Advances in the Understanding of Vestibular Migraine

Sohn

2016

Behavioural Neurology

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Approximately 1% of the general population and 10% of patients with migraine suffer from vestibular migraine (VM). However, this condition remains relatively unknown; therefore, it is often underdiagnosed despite the recent adoption of international diagnostic criteria for VM. The diagnosis of VM is based on the symptoms, degree, frequency, and duration of the vestibular episodes, a history of migraine, the temporal association of migraine symptoms with vestibular episodes in at least 50% of cases, and the exclusion of other causes. Physical examination and laboratory findings are usually normal in patients with VM but can be used to rule out other vestibular disorders with similar symptoms. The pathophysiology of VM remains incompletely understood; however, several mechanisms link the trigeminal system, which is activated during migraine attacks, and the vestibular system. Because few controlled trials have specifically investigated VM, the treatment options for this order are largely the same as those for migraine and include antiemetics for severe acute attacks, pharmacological migraine prophylaxis, and lifestyle changes.

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Section: Epidemiology Of Vmmentioning

confidence: 99%

Recent Advances in the Understanding of Vestibular Migraine

Sohn

2016

Behavioural Neurology

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“…[11] Magnetic resonance imaging studies report possible pathoanatomic connections between the pain and vestibular systems in migraine. [12] Another functional imaging study reported increased metabolism of the temporo-parietal-insular areas and bilateral thalami in two VM patients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of phonophobia with audiological tests in vestibular migraine patients

Göde¹

2017

Kulak Burun Bogaz Ihtis Derg

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Objectives: This study aims to review the diagnostic value of loudness discomfort level (LDL) and short increment sensitivity index (SISI) measurements in patients with vestibular migraine. Patients and Methods:The study included 20 vestibular migraine patients (group 1; 5 males, 15 females; mean age 42.1 years; range 16 to 60 years) and 20 healthy controls (group 2; 6 males, 14 females; mean age 20.3 years; range 18 to 30 years). Pure tone audiometry, SISI, tympanometry, and LDL test were performed. Results:Median LDL scores in groups 1 and 2 were 99.50 dB (interquartile range: 19.5) and 105 dB (interquartile range: 6), respectively. LDL scores were significantly lower in group 1 (p<0.05). According to the receiver operating characteristic analysis of LDL measurements, the area under curve was 0.76 (p<0.05) when vestibular migraine was the selection criterion. When 103.5 dB was taken as the cut-off point, the sensitivity of LDL test was 75% and specificity was 82%. There was no significant relationship between the SISI scores and phonophobia (p>0.05). Conclusion:To our knowledge, this is the first study to show the potential diagnostic value of LDL as an audiological test in vestibular migraine. Further studies are warranted to elucidate the diagnostic value of LDL in the differential diagnosis of episodic vertigo.Keywords: Loudness discomfort level; phonophobia; short increment sensitivity index; vestibular migraine. ÖZAmaç: Bu çalışmada vestibüler migren hastalarında rahatsız edici ses düzeyi (LDL) ve short increment sensitivity index (SISI) ölçümlerinin tanısal değeri incelendi. Bulgular: Grup 1 ve 2'de medyan LDL skorları sırasıyla 99.50 dB (çeyrekler açıklığı: 19.5) ve 105 dB (çeyrekler açıklığı: 6) idi. LDL skorları grup 1'de anlamlı olarak daha düşük idi (p<0.05). Vestibüler migren seçim ölçütü olduğunda, LDL ölçümlerinin alıcı işletim karakteristiği analizine göre eğri altında kalan alan 0.76 (p<0.05) idi. Eşik noktası olarak 103.5 dB belirlendiğinde, LDL testinin duyarlılığı %75, özgüllüğü ise %82 idi. SISI skorları ve fonofobi arasında anlamlı ilişki yoktu (p>0.05).Sonuç: Bildiğimiz kadarıyla, LDL'nin vestibüler migrende bir odyolojik test olarak potansiyel tanısal değerini gösteren ilk çalışma budur. LDL'nin epizodik vertigonun ayırıcı tanısındaki tanısal değerinin aydınlatılması için ileri çalışmalara gereksinim vardır.Anahtar Sözcükler: Rahatsız edici ses düzeyi; fonofobi; short increment sensitivity index; vestibüler migren.

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“…Actually, VM was only added in the appendix of the ICHD-3 beta. Diversity of nomenclature and different diagnostic approaches, besides the intrinsic complexity of the diagnosis itself [37], led to the elaboration of consistent criteria, that could contribute to organize and homogenize VM clinical approach (see “ICHD-3 Beta Diagnostic Criteria of Vestibular Migraine”).…”

Section: Migraine Clinical Manifestationsmentioning

confidence: 99%

“…Drugs such as calcium-channel blockers, namely, flunarizine and cinnarizine, are popular in VM prophylactic treatment. Cinnarizine was tested in a retrospective, single-centre, open-label study on VM and migraine associated with vertigo, in 1993, in 24 patients [37]. The conclusion was that the drug was safe and effective in reducing both headache and vertigo aspects of “migraine plus vertigo” among patients who suffer from either VM or MBA associated with vertigo [96].…”

Section: Treatmentmentioning

confidence: 99%

Vestibular Migraine: Clinical Challenges and Opportunities for Multidisciplinarity

Luzeiro

Luis²,

Gonçalves

et al. 2016

Behavioural Neurology

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Migraine and vertigo are two very prevalent conditions in general population. The coexistence of both in the same subject is a significant clinical challenge, since it is not always possible to understand whether they are causally related or associated by chance, requiring different diagnostic and therapeutic approaches. In this review we analyze and summarize the actual knowledge about vestibular migraine (VM), focusing on the new concepts proposed by the International Classification of Headache Disorders 3-beta and by the Bárány Society and also addressing the former concepts, which are still present in clinical practice. We conclude that clinical studies using a multidisciplinary approach are crucial in this field, since different specialists observe the same pathology with different eyes. Clinical presentation of VM is variable in what concerns vestibular symptoms temporal relation with migraine headache, as well as in their accompanying manifestations. Biomarkers, either genomics or functional, and molecular imaging techniques will be helpful to clarify many aspects of the complexity of this entity, helping to define to what extent can VM be considered a separate and independent clinical entity.

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Vestibular migraine: the most frequent entity of episodic vertigo

Cited by 221 publications

References 85 publications

Recent Advances in the Understanding of Vestibular Migraine

Recent Advances in the Understanding of Vestibular Migraine

Evaluation of phonophobia with audiological tests in vestibular migraine patients

Vestibular Migraine: Clinical Challenges and Opportunities for Multidisciplinarity

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