Characteristic differences between vestibular migraine and migraine only patients

DOI: https://doi.org/10.1007/s00415- 021- 10636- 0

Abstract-Summary Our aims were to find out how VM patients differ from migraine only (MO) patients, to evaluate co-morbid depression in these two groups and to determine if their dis- ease has an effect on their quality of life.

VM patients were also asked about their vertigo attacks and accompanying

symptoms.

Each patient also completed the following questionnaires: (1) Migraine Disability Assessment Scale (MIDAS); (2) headache severity with VAS (Visual Analog Scale); (3) Allodynia Symptom Checklist (ASC-12); (4) Beck Depression Inventory (BDI); (5) World Health Organization Quality of Life Questionnaire Short Form-12 (WHOQL-SF12); (6) Activities Specific Balance Confidence Scale (ABC).

We found that VM patients were more likely than MO patients to be female, post-menopausal, depressed, motion sick, complaining of imbalance and of food- triggered headaches.

MO patients were more likely than VM patients to have severe headaches and

that these can be triggered by certain odors and by noise.

Extended: VM patients were recruited at Neurology Balance Clinic and were diagnosed by a neuro-otologist (GA) after excluding other etiologies which could cause recurrent vertigo attacks.

We found that certain foods triggered headache in VM patients but not in MO

patients.

Introduction The link between migraine and vertigo was regonized over 100 years ago [298].

Although VM is one of the most common cause of recurrent spontaneous vertigo affecting people in the productive years of life [299] it is not generally recognized in primary care, so that patients are referred for neurological consultation and can then be subjected to needless investigations.

We wanted to find out how VM patients differ from migraine only (MO) patients.

Materials and Methods We studied 50 definite VM patients and 35 MO patients, diagnosed according to the ICHD-3 beta (appendix A 1.6.5) criteria and episodic migraine with or without aura (primary headache section) [11]. '

MO group were patients who did not have any vestibular complaints and were

matched with VM group for age and gender.

VM patients were also asked about their vertigo attacks and accompanying

symptoms.

Of univariate analysis, variables with a statistical significance which provided p  <  0.20 for differential diagnosis between VM and MO, the variables were

3.3 Clinical Diagnosis

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menopause, aggregating variables: the presence of odor, noise, and the main con- founding variable, sex, and age were examined in two different models.

While the dependent variable was examined in VM/MO model, dichotomous

was categorized as VM = 1 and MO = 0.

Results Balance confidence scores (ABC) were lower in VM than in MO patients (p < 000.1) and Beck Depression Inventory (BDI) scores were higher in VM than in MO patients (p < 0.05).

While questioning foods that trigger migraine headache, seven patients in VM stated food trigger for their headache but none of the patients in MO stated food trigger for their headache.

Some VM patients had auditory symptoms with vertigo attacks: 7 had tinnitus, 2 had aural fulness but all had normal audiograms accounting for age and noise exposure.

Discussion This is the first study to show that headache intensity differs between VM and MO. We found that certain foods triggered headache in VM patients but not in MO

patients.

VM and MO both affect the quality of life due to headache and this effect

increases in patients with VM, due to the additional effects of vertigo [300].

Due to vertigo attacks VM patients experience more depression and lower qual-

ity of life than MO patients [301].

We show that VM patients differs from MO patients, in terms of increased motion sickness, depression, lower quality of life due to vertigo attacks, but lower headache intensity.

A strength of the study is the accurate selection of patients: VM diagnosed by a

neuro-otologist and MO by headache specialist.

Acknowledgement A machine generated summary based on the work of Özçelik, Pınar; Koçoğlu, Koray; Öztürk, Vesile; Keskinoğlu, Pembe; Akdal, Gülden. 2021  in Journal of Neurology.

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