Vestibular migraine: Our experiences at a tertiary care teaching hospital of Eastern India

Abstract

Introduction: The etiopathology and management of vestibular migraine (VM) are a puzzling dilemma among the clinician. The migraine and vertigo are important symptoms of VM. Objective: Clinical and audio-vestibular evaluation of VM patients. Materials and Methods: It is a prospective study which was conducted between June 2016 and May 2019. Patients attending vertigo clinic were thoroughly reviewed. The patients of VM were selected on the basis of criteria fulfilling the International classification of headache disorders, 3rd edition (beta version). Neuro-otological examinations with videonystagmography (VNG) and vestibular evoked myogenic potentials (VEMPs) tests were done in all cases those diagnosed for VM. Results: There were 51 VM patients out of 168 dizzy patients during the study period. Aural fullness (45.09%) was the most common aural symptom, followed by tinnitus and hearing loss. Phonophobia (82.35%) was the most common migrainous symptom. The relation between headache and menstrual period among female patients was significant. VNG was showing abnormality in 11.76% of cases during caloric test with the highest abnormality in positional test. In VEMPs, 32 patients (62.74%) had abnormal cervical VEMPs response, whereas abnormal ocular VEMPs response seen 38 patients (74.50%). Conclusion: VM is a leading cause of vertigo in the clinical practice and high percentage of patients presented with abnormalities in VNG and VEMPs during vestibular symptoms. Proper history taking and neuro-otological examination and vestibular investigations help for the early diagnosis and treatment.

Keywords

• dizziness
• migraine
• vertigo
• vestibular evoked myogenic potentials
• vestibular migraine