Migraine Briefs

Vestibular Migraine: Clinical Features and Triggers

Headache; ePub 2019 Feb 8; Beh, Masrour, et al.


Vestibular migraine (VM) typically affects women in their 40s with a personal and family history of migraine, according to a recent study. Typical ictal symptoms were triggered as well as spontaneous vertigo (associated with photophobia and phonophobia), nausea, aural symptoms, and headache. In addition, interictal vestibular symptoms, comorbid psychiatric disorders, and non‐specific interictal neuro‐otologic findings were common. Researchers evaluated a retrospective chart review of 491 patients seen from August 2014 until March 2018 at a tertiary neurology referral center for vestibular disorders to identify patients fulfilling the 2012 VM criteria. There were 131 patients (105 women) identified; mean age of VM onset was 44.3 (±13.7) years. They found:

  • Preceding the onset of vestibular symptoms, most had migraine (57.3%) and motion sickness (61.1%).

  • It was common to have a family history of migraine (50.8%) and episodic vestibular symptoms (28.1%).

  • Common ictal symptoms were triggered (visually induced and head‐motion) and spontaneous vertigo, accompanied by photophobia and phonophobia (118/131 [90.1%] patients), nausea (105/131 [80.2%] patients), aural symptoms (79/131 [60.3%] patients), and headache (65/131 [49.6%] patients).

  • Interictally, many experienced visually induced (116/131 [88.6%] patients), head‐motion (86/131 [65.6%] patients), and persistent (67/131 [51.1%] patients) dizziness.

Beh SC, Masrour S, Smith SV, Friedman DI. The spectrum of vestibular migraine: Clinical features, triggers, and examination findings. [Published online ahead of print February 8, 2019]. Headache. doi:10.1111/head.13484.

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