A new perspective on the clinical features of vestibular migraine

Abstract Background Diagnosis of vestibular migraine (VM) is complicated by its variable clinical presentation and lack of pathognomonic tests. Results Two-hundred fifty-eight vestibular attacks of 141 patients were evaluated. In a total of 141 patients, 26% of patients reported no headache. A total...

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Main Authors: Gülin Gökçen Kesici, Büşra Kaplan
Format: Article
Language:English
Published: SpringerOpen 2024-12-01
Series:The Egyptian Journal of Otolaryngology
Subjects:
Online Access:https://doi.org/10.1186/s43163-024-00740-z
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author Gülin Gökçen Kesici
Büşra Kaplan
author_facet Gülin Gökçen Kesici
Büşra Kaplan
author_sort Gülin Gökçen Kesici
collection DOAJ
description Abstract Background Diagnosis of vestibular migraine (VM) is complicated by its variable clinical presentation and lack of pathognomonic tests. Results Two-hundred fifty-eight vestibular attacks of 141 patients were evaluated. In a total of 141 patients, 26% of patients reported no headache. A total of 81% of the patients without headache reported pressure heaviness in the head and head numbness and reported aggravation of these symptoms by routine physical activity. In the group of pVM, 23 patients could not be classified as dVM; they had present or past history of migraine but did not have migrainous characteristics in at least 50% of their vestibular attacks, and 15 of these patients were diagnosed with dVM during follow-up. At least mild central ocular signs were observed in 59 (22%), and impairment in vVOR test (horizontal and/or vertical) was observed in 81 (31%) of 258 vestibular attacks. In vHIT test, 68 (26%) attacks with low VOR gain and refixation saccades and 151 (58%) attacks with normal VOR gain and pathological saccades were detected. Conclusions The heterogeneity in clinical and vestibular tests detected in this study, both in patients and in different attacks of the same patients, revealed the importance of taking a detailed history in the diagnosis of VM.
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spelling doaj-art-d672377ca0cc4d01a6ea47262d09c9ae2025-08-20T02:43:24ZengSpringerOpenThe Egyptian Journal of Otolaryngology2090-85392024-12-014011710.1186/s43163-024-00740-zA new perspective on the clinical features of vestibular migraineGülin Gökçen Kesici0Büşra Kaplan1Department of Otorhinolaryngology - Head and Neck Surgery, Ankara Medipol UniversityDepartment of Audiology, Faculty of Health Sciences, Ankara Medipol UniversityAbstract Background Diagnosis of vestibular migraine (VM) is complicated by its variable clinical presentation and lack of pathognomonic tests. Results Two-hundred fifty-eight vestibular attacks of 141 patients were evaluated. In a total of 141 patients, 26% of patients reported no headache. A total of 81% of the patients without headache reported pressure heaviness in the head and head numbness and reported aggravation of these symptoms by routine physical activity. In the group of pVM, 23 patients could not be classified as dVM; they had present or past history of migraine but did not have migrainous characteristics in at least 50% of their vestibular attacks, and 15 of these patients were diagnosed with dVM during follow-up. At least mild central ocular signs were observed in 59 (22%), and impairment in vVOR test (horizontal and/or vertical) was observed in 81 (31%) of 258 vestibular attacks. In vHIT test, 68 (26%) attacks with low VOR gain and refixation saccades and 151 (58%) attacks with normal VOR gain and pathological saccades were detected. Conclusions The heterogeneity in clinical and vestibular tests detected in this study, both in patients and in different attacks of the same patients, revealed the importance of taking a detailed history in the diagnosis of VM.https://doi.org/10.1186/s43163-024-00740-zDefinite vestibular migraineProbable vestibular migraineSuspected vestibular migraineHeadacheClinical heterogeneity
spellingShingle Gülin Gökçen Kesici
Büşra Kaplan
A new perspective on the clinical features of vestibular migraine
The Egyptian Journal of Otolaryngology
Definite vestibular migraine
Probable vestibular migraine
Suspected vestibular migraine
Headache
Clinical heterogeneity
title A new perspective on the clinical features of vestibular migraine
title_full A new perspective on the clinical features of vestibular migraine
title_fullStr A new perspective on the clinical features of vestibular migraine
title_full_unstemmed A new perspective on the clinical features of vestibular migraine
title_short A new perspective on the clinical features of vestibular migraine
title_sort new perspective on the clinical features of vestibular migraine
topic Definite vestibular migraine
Probable vestibular migraine
Suspected vestibular migraine
Headache
Clinical heterogeneity
url https://doi.org/10.1186/s43163-024-00740-z
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