Association between migraine and vestibular disorders

Dizziness (vertigo) and migraine headache are among the most common neurological disorders. The association of dizziness and migraine in the population occurs more often than these conditions diagnosed separately. The probability of their random coincidence is about 1% among the adult population, an...

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Main Authors: D. M. Gassieva, M. V. Zamergrad, G. R. Tabeeva
Format: Article
Language:Russian
Published: IRBIS LLC 2019-04-01
Series:Эпилепсия и пароксизмальные состояния
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Online Access:https://www.epilepsia.su/jour/article/view/461
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author D. M. Gassieva
M. V. Zamergrad
G. R. Tabeeva
author_facet D. M. Gassieva
M. V. Zamergrad
G. R. Tabeeva
author_sort D. M. Gassieva
collection DOAJ
description Dizziness (vertigo) and migraine headache are among the most common neurological disorders. The association of dizziness and migraine in the population occurs more often than these conditions diagnosed separately. The probability of their random coincidence is about 1% among the adult population, and the prevalence of migraines combined with dizziness is 3.2%, i. e. about 3 times higher than a mere coincidence. Epidemiological studies have found that the associations between migraine and vertigo is bi-directional. On the one hand, migraine is more common among patients with dizziness, and on the other hand, dizziness is more common among patients with migraine. Moreover, such comorbidity with dizziness is more typical for migraine, and not for other forms of headache. On this background, the term “migraine-associated dizziness”, or “vestibular migraine” (VM) has been introduced. In 2001, H. Neuhauser et al. proposed a list of diagnostic criteria for VM, and this condition has been recently included in the ICDB-3 beta version as a separate nosological unit. By now, the pathophysiology of the VM is not well understood; the current hypotheses are mainly based on the pathophysiology of migraine itself. Yet, a number of recent studies have made a significant contribution to the understanding of the neurophysiological processes involved in the development of VM. There is a hypothesis that dizziness in migraine represents a migraine aura; this mechanism is based on the phenomenon of spreading cortical depression, i. e., a wave of depolarization that originates in the occipital cortex and slowly moves to the ventrally located areas. Vestibular disorders are known to be caused by the release of neuropeptides (substance P, neurokinin A, calcitonin-like peptide); these peptides stimulate the impulse activity of the sensory epithelium in the inner ear and the vestibular nuclei of the brain stem. In addition to the existence of vestibular migraine, as an independent form of headache, other migraine-associated vestibular disorders have been identified. The most commonly seen are nonspecific symptoms, e. g., motion sickness (that occurs in about 50% of patients), peripheral vestibulopathies, and subclinical vestibular disorders detected in patients with migraine by an instrumental neurovestibular examination in the interictal period. The precise mechanisms of the association between migraine and vertigo are not well understood. Clarifying the clinical and pathophysiological details of the relationship between these conditions is very important for optimal management of patients with migraine.
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spelling doaj-art-c17662dda2ec4632bb05fdc13351f3a52025-08-20T03:57:32ZrusIRBIS LLCЭпилепсия и пароксизмальные состояния2077-83332311-40882019-04-01111889610.17749/2077-8333.2019.11.1.88-96437Association between migraine and vestibular disordersD. M. Gassieva0M. V. Zamergrad1G. R. Tabeeva2Sechenov First Moscow State Medical University, Ministry of Health of RussiaRussian Medical Academy of Postgraduate Education Pirogov Russian National Research Medical University Medical Center “Guta Clinics”Sechenov First Moscow State Medical University, Ministry of Health of RussiaDizziness (vertigo) and migraine headache are among the most common neurological disorders. The association of dizziness and migraine in the population occurs more often than these conditions diagnosed separately. The probability of their random coincidence is about 1% among the adult population, and the prevalence of migraines combined with dizziness is 3.2%, i. e. about 3 times higher than a mere coincidence. Epidemiological studies have found that the associations between migraine and vertigo is bi-directional. On the one hand, migraine is more common among patients with dizziness, and on the other hand, dizziness is more common among patients with migraine. Moreover, such comorbidity with dizziness is more typical for migraine, and not for other forms of headache. On this background, the term “migraine-associated dizziness”, or “vestibular migraine” (VM) has been introduced. In 2001, H. Neuhauser et al. proposed a list of diagnostic criteria for VM, and this condition has been recently included in the ICDB-3 beta version as a separate nosological unit. By now, the pathophysiology of the VM is not well understood; the current hypotheses are mainly based on the pathophysiology of migraine itself. Yet, a number of recent studies have made a significant contribution to the understanding of the neurophysiological processes involved in the development of VM. There is a hypothesis that dizziness in migraine represents a migraine aura; this mechanism is based on the phenomenon of spreading cortical depression, i. e., a wave of depolarization that originates in the occipital cortex and slowly moves to the ventrally located areas. Vestibular disorders are known to be caused by the release of neuropeptides (substance P, neurokinin A, calcitonin-like peptide); these peptides stimulate the impulse activity of the sensory epithelium in the inner ear and the vestibular nuclei of the brain stem. In addition to the existence of vestibular migraine, as an independent form of headache, other migraine-associated vestibular disorders have been identified. The most commonly seen are nonspecific symptoms, e. g., motion sickness (that occurs in about 50% of patients), peripheral vestibulopathies, and subclinical vestibular disorders detected in patients with migraine by an instrumental neurovestibular examination in the interictal period. The precise mechanisms of the association between migraine and vertigo are not well understood. Clarifying the clinical and pathophysiological details of the relationship between these conditions is very important for optimal management of patients with migraine.https://www.epilepsia.su/jour/article/view/461migrainedizzinesssubclinical vestibular disordersmotion sicknessperipheral vestibulopathy
spellingShingle D. M. Gassieva
M. V. Zamergrad
G. R. Tabeeva
Association between migraine and vestibular disorders
Эпилепсия и пароксизмальные состояния
migraine
dizziness
subclinical vestibular disorders
motion sickness
peripheral vestibulopathy
title Association between migraine and vestibular disorders
title_full Association between migraine and vestibular disorders
title_fullStr Association between migraine and vestibular disorders
title_full_unstemmed Association between migraine and vestibular disorders
title_short Association between migraine and vestibular disorders
title_sort association between migraine and vestibular disorders
topic migraine
dizziness
subclinical vestibular disorders
motion sickness
peripheral vestibulopathy
url https://www.epilepsia.su/jour/article/view/461
work_keys_str_mv AT dmgassieva associationbetweenmigraineandvestibulardisorders
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