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Investigation of the coherence of definite and probable vestibular migraine as distinct clinical entities.
Otol Neurotol. 2011 Sep; 32(7):1144-51.ON

Abstract

OBJECTIVES

To investigate the following: 1) associations between vestibular symptoms and migraine in a well-characterized cohort of tertiary neurotology patients, 2) effects of comorbidity on clinical presentations, and 3) validity of proposed definitions of definite (dVM) and probable vestibular migraine (pVM).

STUDY DESIGN

Retrospective chart review.

SETTING

Tertiary neurotology center.

PATIENTS

All 228 subjects with headache were selected from a larger investigation of 410 patients with vestibular symptoms who underwent comprehensive medical, surgical, and behavioral neurotologic consultations. Subjects had at least one of 4 diagnoses: dVM/pVM, Ménière's disease, benign paroxysmal positional vertigo, or chronic subjective dizziness.

INTERVENTIONS

Subjects were divided into migraine (n = 164) and nonmigraine headache (n = 64) groups by International Headache Society criteria, then subdivided by those with vestibular symptoms related or unrelated to headache. Subjects meeting proposed criteria for dVM (n = 46) and pVM (n = 42) were identified. Statistical analyses investigated discriminating features and cohesiveness in each group, with or without comorbidity.

MAIN OUTCOME MEASURES

Characteristics of dVM and pVM.

RESULTS

Migraine, particularly migraine with aura, was more often related to vestibular symptoms than nonmigrainous headache. dVM and pVM groups did not differ in demographics, clinical histories, examinations, or vestibular testing. Numerous differences existed between dVM/pVM subjects with and without comorbid Ménière's disease, benign paroxysmal positional vertigo, or chronic subjective dizziness. The pVM group contained 4 subtypes.

CONCLUSION

These results support an association between vestibular symptoms and migraine but not proposed distinctions between dVM and pVM. pVM does not appear to be a coherent diagnostic entity. Comorbid conditions are important causes of vestibular symptoms in patients with migraine.

Authors+Show Affiliations

Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905, USA. eggers.scott@mayo.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21799457

Citation

Eggers, Scott D Z., et al. "Investigation of the Coherence of Definite and Probable Vestibular Migraine as Distinct Clinical Entities." Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, vol. 32, no. 7, 2011, pp. 1144-51.
Eggers SD, Staab JP, Neff BA, et al. Investigation of the coherence of definite and probable vestibular migraine as distinct clinical entities. Otol Neurotol. 2011;32(7):1144-51.
Eggers, S. D., Staab, J. P., Neff, B. A., Goulson, A. M., Carlson, M. L., & Shepard, N. T. (2011). Investigation of the coherence of definite and probable vestibular migraine as distinct clinical entities. Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 32(7), 1144-51. https://doi.org/10.1097/MAO.0b013e31822a1c67
Eggers SD, et al. Investigation of the Coherence of Definite and Probable Vestibular Migraine as Distinct Clinical Entities. Otol Neurotol. 2011;32(7):1144-51. PubMed PMID: 21799457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Investigation of the coherence of definite and probable vestibular migraine as distinct clinical entities. AU - Eggers,Scott D Z, AU - Staab,Jeffrey P, AU - Neff,Brian A, AU - Goulson,Adam M, AU - Carlson,Matthew L, AU - Shepard,Neil T, PY - 2011/7/30/entrez PY - 2011/7/30/pubmed PY - 2011/12/17/medline SP - 1144 EP - 51 JF - Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology JO - Otol Neurotol VL - 32 IS - 7 N2 - OBJECTIVES: To investigate the following: 1) associations between vestibular symptoms and migraine in a well-characterized cohort of tertiary neurotology patients, 2) effects of comorbidity on clinical presentations, and 3) validity of proposed definitions of definite (dVM) and probable vestibular migraine (pVM). STUDY DESIGN: Retrospective chart review. SETTING: Tertiary neurotology center. PATIENTS: All 228 subjects with headache were selected from a larger investigation of 410 patients with vestibular symptoms who underwent comprehensive medical, surgical, and behavioral neurotologic consultations. Subjects had at least one of 4 diagnoses: dVM/pVM, Ménière's disease, benign paroxysmal positional vertigo, or chronic subjective dizziness. INTERVENTIONS: Subjects were divided into migraine (n = 164) and nonmigraine headache (n = 64) groups by International Headache Society criteria, then subdivided by those with vestibular symptoms related or unrelated to headache. Subjects meeting proposed criteria for dVM (n = 46) and pVM (n = 42) were identified. Statistical analyses investigated discriminating features and cohesiveness in each group, with or without comorbidity. MAIN OUTCOME MEASURES: Characteristics of dVM and pVM. RESULTS: Migraine, particularly migraine with aura, was more often related to vestibular symptoms than nonmigrainous headache. dVM and pVM groups did not differ in demographics, clinical histories, examinations, or vestibular testing. Numerous differences existed between dVM/pVM subjects with and without comorbid Ménière's disease, benign paroxysmal positional vertigo, or chronic subjective dizziness. The pVM group contained 4 subtypes. CONCLUSION: These results support an association between vestibular symptoms and migraine but not proposed distinctions between dVM and pVM. pVM does not appear to be a coherent diagnostic entity. Comorbid conditions are important causes of vestibular symptoms in patients with migraine. SN - 1537-4505 UR - https://www.unboundmedicine.com/medline/citation/21799457/Investigation_of_the_coherence_of_definite_and_probable_vestibular_migraine_as_distinct_clinical_entities_ L2 - https://doi.org/10.1097/MAO.0b013e31822a1c67 DB - PRIME DP - Unbound Medicine ER -