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Original article • Braz. j. otorhinolaryngol. 88 (Suppl 3) • Nov-Dec 2022 • https://doi.org/10.1016/j.bjorl.2021.12.004   copy

Clinical characteristics of definite vestibular migraine diagnosed according to criteria jointly formulated by the Bárány Society and the International Headache Society

Authorship SCIMAGO INSTITUTIONS RANKINGS

Highlights

Definite Vestibular Migraine (dVM) is more common in women.

The onset of migraine precedes that of vestibular symptoms, which are often accompanied by photophobia and phonophobia.

Most patients develop motion sickness and cannot tolerate the caloric test, which can contribute to dVM diagnosis.

Motion sickness and severe caloric test intolerance can contribute to the diagnosis of dVM.

Immunological indicators are abnormal in some patients with dVM.

Abstract

Objective:

To investigate the clinical features of patients with definite vestibular migraine (dVM).

Methods:

A total of 91 patients with vestibular symptoms accompanied by migraines/migrainelike symptoms were enrolled and diagnosed according to the criteria of the Bárány Society and the International Headache Society. Baseline data were collected. Videonystagmography and immune-related laboratory tests were performed.

Results:

Among the 91 patients, 62 (68.1%) had dVM (11 men, 51 women). Among dVM patients, migraine occurred earlier than vestibular symptoms in 42 (67.7%) patients. Spontaneous vertigo occurred in 41 (66.1%) patients. Induced vertigo occurred in 21 (33.9%) patients. Motion sickness occurred in 33 (53.2%) patients. Central oculomotor dysfunction was observed in 11 (17.7%) patients. Caloric test revealed unilateral horizontal semicircular canal dysfunction in 12 (19.4%) patients. Severe intolerance during the test occurred in 44 (71.0%) patients with dVM. 12 (19.4%) patients showed abnormal immune-related indicators.

Conclusion:

dVM is more common in women. The onset of migraine precedes that of vestibular symptoms, which are often accompanied by photophobia and phonophobia. Motion sickness and severe caloric test intolerance can contribute to the diagnosis of dVM. Immunological indicators are abnormal in some patients with dVM, dVM may be secondary or an accompanying disorder, but the causal relationship needs further investigation.

Level of evidence: IV.

Keywords
Vestibular migraine; Vestibule; Migraine; Videonystagmography; Immunology

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br
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