Vestibular function in patients with vestibular migraine
,
Abstract
Background and Aim: Vestibular migraine is a type of migraine that causes vertigo, dizziness, and imbalance in addition to typical migraine symptoms. In this study, we aimed to investigate vestibular system in these patients by videonystagmography (VNG), electrocochleography (ECochG), and vestibular evoked myogenic potential (VEMP) testing.
Methods: This empirical study was conducted on 10 patients aged 18-45 years old (mean age: 29.7 years) with vestibular migraine and 10 normal subjects (mean age: 30.9 years). Immittance, audiometry, VNG, ECochG, and VEMP tests were performed in attack-free phase in both groups.
Results: Mean value of spontaneous nystagmus was significantly higher in patients compared to the normal subjects (p<0.05). There was no statistically significant difference in oculomotor, positional, caloric, and ECochG test results between the two groups (p>0.05). In positional test, pathologic nystagmus was detected in four patients with vestibular migraine, but there was not any significant difference between the two groups in this regard (p>0.05). Mean p13-n23 amplitude was significantly lower and mean p13 latency was significantly higher in the vestibular migraine patients than that of the control group.
Conclusion: Vestibular malfunction was more prevalent in patients with migraine than the control group even between attacks. This malfunction can be observed in both peripheral and central systems. Due to heterogeneity of vestibular disorders in patients with vestibular migraine and the variety of pathologic mechanisms that affect its occurrence and progression, conducting one test alone cannot be helpful in diagnosis; thus, test battery approach is crucial.
1. Maslovara S, Soldo SB, Pajić-Penavić I, Alkhamis T, Vešligaj T, Soldo A. Vestibular migraine considering new diagnostic criteria. Neurol Croat. 2014;63(1-2):11-8.
2. Lempert T, Neuhauser H. Epidemiology of vertigo, migraine and vestibular migraine. J Neurol. 2009;256(3):333-8.
3. Hazzaa N, El Mowafy SS. Clinical features of vestibular migraine in Egypt. Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 2016;17(1):17-21.
4. Dash AK, Panda N, Khandelwal G, Lal V, Mann SS. Migraine and audiovestibular dysfunction: is there a correlation? Am J Otolaryngol. 2008;29(5):295-9.
5. von Brevern M, Zeise D, Neuhauser H, Clarke AH, Lempert T. Acute migrainous vertigo: clinical and ocu-lographic findings. Brain. 2005;128(Pt 2):365-74.
6. Baloh RW, Honrubia V, Kerber KA. Baloh and Honrubia's clinical neurophysiology of the vestibular system. 4th ed. New York: Oxford University Press; 2011.
7. Abbas PJ, Brown CJ. Electrocochleography. In: Katz J, Medwetsky L, Burkard R, Hood J, editors. Handbook of clinical audiology. 6th ed. Baltimore: Lippincott Williams & Wilkins; 2009. p. 242-64.
8. Neugebauer H, Adrion C, Glaser M, Strupp M. Long-term changes of central ocular motor signs in patients with vestibular migraine. Eur Neurol. 2013;69(2):102-7.
9. Dieterich M, Brandt T. Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol. 1999;246(10):883-92.
10. Kayan A, Hood JD. Neuro-otological manifestations of migraine. Brain. 1984;107 (Pt 4):1123-42.
11. Bir LS, Ardiç FN, Kara CO, Akalin O, Pinar HS, Celiker A. Migraine patients with or without vertigo: comparison of clinical and electronystagmographic findings. J Otolaryngol. 2003;32(4):234-8.
12. Lempert T, Olesen J, Furman J, Waterston J, Seemungal B, Carey J, et al. Vestibular migraine: diagnostic criteria. J Vestib Res. 2012;22(4):167-72.
13. Polensek SH, Tusa RJ. Nystagmus during attacks of vestibular migraine: an aid in diagnosis. Audiol Neurootol. 2010;15(4):241-6.
14. Celebisoy N, Gökçay F, Sirin H, Biçak N. Migrainous vertigo: clinical, oculographic and posturographic findings. Cephalalgia. 2008;28(1):72-7.
15. Vitkovic J, Paine M, Rance G. Neuro-otological findings in patients with migraine- and nonmigraine-related diz-ziness. Audiol Neurootol. 2008;13(2):113-22.
16. Rzeski M, Stepień A, Kaczorowski Z. Evaluation of the function of the vestibular system in patients with migraine. Neurol Neurochir Pol. 2008;42(6):518-24.
17. Khalil LH, Hazzaa NM, Nour AA. Vestibular migraine: A orrelation study between clinical findings and vestibular evoked myogenic potentials (VEMPs). Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 2016;17(1):11-6.
18. Roberts RA, Gans RE. Background, technique, inter-pretation and usefulness of positional/positioning testing. In: Jacobson GP, Shepard NT, editors. Balance function assessment and management. 1st ed. San Diego: Plural Publishing Inc; 2008. p. 171-96.
19. Yetiser S, Gokmen MH. Clinical aspects of benign paroxysmal positional vertigo associated with migraine. Int Tinnitus J. 2015;19(2):64-8.
20. Ishiyama A, Jacobson KM, Baloh RW. Migraine and benign positional vertigo. Ann Otol Rhinol Laryngol. 2000;109(4):377-80.
21. von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007;78(7):710-5.
22. Uneri A. Migraine and benign paroxysmal positional vertigo: an outcome study of 476 patients. Ear Nose Throat J. 2004;83(12):814-5.
23. Allena M, Magis D, De Pasqua V, Schoenen J, Bisdorff AR. The vestibulo-collic reflex is abnormal in migraine. Cephalalgia. 2007;27(10):1150-5.
24. Wu ZM, Zhang SZ, Zhou N, Liu XJ, Ji F, Chen AT, et al. Neurootological manifestation of migrainous vertigo. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2006;41(10):726-30. Chinese.
25. Boldingh MI, Ljøstad U, Mygland A, Monstad P. Vestibular sensitivity in vestibular migraine: VEMPs and motion sickness susceptibility. Cephalalgia. 2011;31(11):1211-9.
26. Baier B, Dieterich M. Vestibular-evoked myogenic potentials in "vestibular migraine" and Menière's disease: a sign of an electrophysiological link? Ann N Y Acad Sci. 2009;1164:324-7.
27. Zuniga MG, Janky KL, Schubert MC, Carey JP. Can vestibular-evoked myogenic potentials help differentiate Ménière disease from vestibular migraine? Otolaryngol Head Neck Surg. 2012;146(5):788-96.
28. Moallemi M, Hajiabolhassan F, Fatahi J, Abolfazli R, Jalaie S, Khamseh F. Vestibular evoked myogenic potentials in migraine patients. Audiol. 2011;20(1):16-25. Persian.
29. Baier B, Stieber N, Dieterich M. Vestibular-evoked myogenic potentials in vestibular migraine. J Neurol. 2009;256(9):1447-54.
30. Parker W. Migraine and the vestibular system in adults. Am J Otol. 1991;12(1):25-34.
31. Ghali AA, Kolkaila EA. Migrainous vertigo: clinical and vestibular evoked myogenic potential (VEMP) findings.
Egypt J Neurol Psychiat Neurosurg. 2005;42(2):341-50.
32. Liao LJ, Young YH. Vestibular evoked myogenic potentials in basilar artery migraine. Laryngoscope. 2004;114(7):1305-9.
33. Welgampola MS, Colebatch JG. Characteristics and clinical applications of vestibular-evoked myogenic potentials. Neurology. 2005;64(10):1682-8.
34. Murofushi T, Shimizu K, Takegoshi H, Cheng PW. Diagnostic value of prolonged latencies in the vestibular evoked myogenic potential. Arch Otolaryngol Head Neck Surg. 2001;127(9):1069-72.
35. Vešligaj T, Maslovara S. Can a finding of cervical vestibular evoked myogenic potentials contribute to vestibular migraine diagnostics? Med Glas (Zenica) 2016; 13(1):36-43.
36. Taylor RL, Zagami AS, Gibson WP, Black DA, Watson SR, Halmagyi MG, et al. Vestibular evoked myogenic potentials to sound and vibration: characteristics in vestibular migraine that enable separation from Meniere's disease. Cephalalgia. 2012;32(3):213-25.
37. Gürkov R, Kantner C, Strupp M, Flatz W, Krause E, Ertl-Wagner B. Endolymphatic hydrops in patients with vestibular migraine and auditory symptoms. Eur Arch Otorhinolaryngol. 2014;271(10):2661-7.
38. Rassekh CH, Harker LA. The prevalence of migraine in Menière's disease. Laryngoscope. 1992;102(2):135-8.
39. Radtke A, Lempert T, Gresty MA, Brookes GB, Bronstein AM, Neuhauser H. Migraine and Ménière's disease: is there a link? Neurology. 2002;59(11):1700-4.
40. Ibekwe TS, Fasunla JA, Ibekwe PU, Obasikene GC, Onakoya PA, Nwaorgu OG. Migraine and Meniere's disease: two different phenomena with frequently observed concomitant occurrences. J Natl Med Assoc. 2008;100(3):334-8.
41. Neff BA, Staab JP, Eggers SD, Carlson ML, Schmitt WR, Van Abel KM, et al. Auditory and vestibular symptoms and chronic subjective dizziness in patients with Ménière's disease, vestibular migraine, and Ménière's disease with concomitant vestibular migraine. Otol Neurotol. 2012;33(7):1235-44.
42. Shepard NT. Differentiation of Ménière's disease and migraine-associated dizziness: a review. J Am Acad Audiol. 2006;17(1):69-80.
43. Cohen JM, Escasena CA. Headache and dizziness: how to differentiate vestibular migraine from other conditions. Curr Pain Headache Rep. 2015;19(7):31.
2. Lempert T, Neuhauser H. Epidemiology of vertigo, migraine and vestibular migraine. J Neurol. 2009;256(3):333-8.
3. Hazzaa N, El Mowafy SS. Clinical features of vestibular migraine in Egypt. Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 2016;17(1):17-21.
4. Dash AK, Panda N, Khandelwal G, Lal V, Mann SS. Migraine and audiovestibular dysfunction: is there a correlation? Am J Otolaryngol. 2008;29(5):295-9.
5. von Brevern M, Zeise D, Neuhauser H, Clarke AH, Lempert T. Acute migrainous vertigo: clinical and ocu-lographic findings. Brain. 2005;128(Pt 2):365-74.
6. Baloh RW, Honrubia V, Kerber KA. Baloh and Honrubia's clinical neurophysiology of the vestibular system. 4th ed. New York: Oxford University Press; 2011.
7. Abbas PJ, Brown CJ. Electrocochleography. In: Katz J, Medwetsky L, Burkard R, Hood J, editors. Handbook of clinical audiology. 6th ed. Baltimore: Lippincott Williams & Wilkins; 2009. p. 242-64.
8. Neugebauer H, Adrion C, Glaser M, Strupp M. Long-term changes of central ocular motor signs in patients with vestibular migraine. Eur Neurol. 2013;69(2):102-7.
9. Dieterich M, Brandt T. Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol. 1999;246(10):883-92.
10. Kayan A, Hood JD. Neuro-otological manifestations of migraine. Brain. 1984;107 (Pt 4):1123-42.
11. Bir LS, Ardiç FN, Kara CO, Akalin O, Pinar HS, Celiker A. Migraine patients with or without vertigo: comparison of clinical and electronystagmographic findings. J Otolaryngol. 2003;32(4):234-8.
12. Lempert T, Olesen J, Furman J, Waterston J, Seemungal B, Carey J, et al. Vestibular migraine: diagnostic criteria. J Vestib Res. 2012;22(4):167-72.
13. Polensek SH, Tusa RJ. Nystagmus during attacks of vestibular migraine: an aid in diagnosis. Audiol Neurootol. 2010;15(4):241-6.
14. Celebisoy N, Gökçay F, Sirin H, Biçak N. Migrainous vertigo: clinical, oculographic and posturographic findings. Cephalalgia. 2008;28(1):72-7.
15. Vitkovic J, Paine M, Rance G. Neuro-otological findings in patients with migraine- and nonmigraine-related diz-ziness. Audiol Neurootol. 2008;13(2):113-22.
16. Rzeski M, Stepień A, Kaczorowski Z. Evaluation of the function of the vestibular system in patients with migraine. Neurol Neurochir Pol. 2008;42(6):518-24.
17. Khalil LH, Hazzaa NM, Nour AA. Vestibular migraine: A orrelation study between clinical findings and vestibular evoked myogenic potentials (VEMPs). Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 2016;17(1):11-6.
18. Roberts RA, Gans RE. Background, technique, inter-pretation and usefulness of positional/positioning testing. In: Jacobson GP, Shepard NT, editors. Balance function assessment and management. 1st ed. San Diego: Plural Publishing Inc; 2008. p. 171-96.
19. Yetiser S, Gokmen MH. Clinical aspects of benign paroxysmal positional vertigo associated with migraine. Int Tinnitus J. 2015;19(2):64-8.
20. Ishiyama A, Jacobson KM, Baloh RW. Migraine and benign positional vertigo. Ann Otol Rhinol Laryngol. 2000;109(4):377-80.
21. von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007;78(7):710-5.
22. Uneri A. Migraine and benign paroxysmal positional vertigo: an outcome study of 476 patients. Ear Nose Throat J. 2004;83(12):814-5.
23. Allena M, Magis D, De Pasqua V, Schoenen J, Bisdorff AR. The vestibulo-collic reflex is abnormal in migraine. Cephalalgia. 2007;27(10):1150-5.
24. Wu ZM, Zhang SZ, Zhou N, Liu XJ, Ji F, Chen AT, et al. Neurootological manifestation of migrainous vertigo. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2006;41(10):726-30. Chinese.
25. Boldingh MI, Ljøstad U, Mygland A, Monstad P. Vestibular sensitivity in vestibular migraine: VEMPs and motion sickness susceptibility. Cephalalgia. 2011;31(11):1211-9.
26. Baier B, Dieterich M. Vestibular-evoked myogenic potentials in "vestibular migraine" and Menière's disease: a sign of an electrophysiological link? Ann N Y Acad Sci. 2009;1164:324-7.
27. Zuniga MG, Janky KL, Schubert MC, Carey JP. Can vestibular-evoked myogenic potentials help differentiate Ménière disease from vestibular migraine? Otolaryngol Head Neck Surg. 2012;146(5):788-96.
28. Moallemi M, Hajiabolhassan F, Fatahi J, Abolfazli R, Jalaie S, Khamseh F. Vestibular evoked myogenic potentials in migraine patients. Audiol. 2011;20(1):16-25. Persian.
29. Baier B, Stieber N, Dieterich M. Vestibular-evoked myogenic potentials in vestibular migraine. J Neurol. 2009;256(9):1447-54.
30. Parker W. Migraine and the vestibular system in adults. Am J Otol. 1991;12(1):25-34.
31. Ghali AA, Kolkaila EA. Migrainous vertigo: clinical and vestibular evoked myogenic potential (VEMP) findings.
Egypt J Neurol Psychiat Neurosurg. 2005;42(2):341-50.
32. Liao LJ, Young YH. Vestibular evoked myogenic potentials in basilar artery migraine. Laryngoscope. 2004;114(7):1305-9.
33. Welgampola MS, Colebatch JG. Characteristics and clinical applications of vestibular-evoked myogenic potentials. Neurology. 2005;64(10):1682-8.
34. Murofushi T, Shimizu K, Takegoshi H, Cheng PW. Diagnostic value of prolonged latencies in the vestibular evoked myogenic potential. Arch Otolaryngol Head Neck Surg. 2001;127(9):1069-72.
35. Vešligaj T, Maslovara S. Can a finding of cervical vestibular evoked myogenic potentials contribute to vestibular migraine diagnostics? Med Glas (Zenica) 2016; 13(1):36-43.
36. Taylor RL, Zagami AS, Gibson WP, Black DA, Watson SR, Halmagyi MG, et al. Vestibular evoked myogenic potentials to sound and vibration: characteristics in vestibular migraine that enable separation from Meniere's disease. Cephalalgia. 2012;32(3):213-25.
37. Gürkov R, Kantner C, Strupp M, Flatz W, Krause E, Ertl-Wagner B. Endolymphatic hydrops in patients with vestibular migraine and auditory symptoms. Eur Arch Otorhinolaryngol. 2014;271(10):2661-7.
38. Rassekh CH, Harker LA. The prevalence of migraine in Menière's disease. Laryngoscope. 1992;102(2):135-8.
39. Radtke A, Lempert T, Gresty MA, Brookes GB, Bronstein AM, Neuhauser H. Migraine and Ménière's disease: is there a link? Neurology. 2002;59(11):1700-4.
40. Ibekwe TS, Fasunla JA, Ibekwe PU, Obasikene GC, Onakoya PA, Nwaorgu OG. Migraine and Meniere's disease: two different phenomena with frequently observed concomitant occurrences. J Natl Med Assoc. 2008;100(3):334-8.
41. Neff BA, Staab JP, Eggers SD, Carlson ML, Schmitt WR, Van Abel KM, et al. Auditory and vestibular symptoms and chronic subjective dizziness in patients with Ménière's disease, vestibular migraine, and Ménière's disease with concomitant vestibular migraine. Otol Neurotol. 2012;33(7):1235-44.
42. Shepard NT. Differentiation of Ménière's disease and migraine-associated dizziness: a review. J Am Acad Audiol. 2006;17(1):69-80.
43. Cohen JM, Escasena CA. Headache and dizziness: how to differentiate vestibular migraine from other conditions. Curr Pain Headache Rep. 2015;19(7):31.
| Files | ||
| Issue | Vol 25 No 3 (2016) | |
| Section | Research Article(s) | |
| Keywords | ||
| Vestibular migraine videonystagmography electrocochleography vestibular evoked myogenic potential | ||
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How to Cite
1.
Lotfi Y, Mardani N, Rezazade N, Saedi Khamene E, Bakhshi E. Vestibular function in patients with vestibular migraine. Aud Vestib Res. 2016;25(3):166-174.
