Migraine and vertigo

2020 ◽  
pp. 128-137
Author(s):  
Yoon-Hee Cha
Keyword(s):  
Migraine Headache ◽  
Clinical Characteristics ◽  
Vestibular Migraine ◽  
Headache Disorders ◽  
Temporal Profile ◽  
Growing Body ◽  
Vestibular Symptoms ◽  
The Common ◽  
Treatment Responses

The phenomena of migraine headache and vertigo share many epidemiological, anatomical, and clinical characteristics. The historically parallel development of the neuroscience of each field has formally intersected in the development of consensus criteria for vestibular migraine and the inclusion of vestibular migraine in the International Classification of Headache Disorders. Differences exist in the temporal profile of head pain and vertigo as manifestations of migraine, which can obscure the association. However, the growing body of evidence on the common demographic, neurochemical signature, and treatment responses of pain and vestibular symptoms indicate that they exist as symptoms of a common syndrome, one which can only be fully understood by recognizing the significance of each kind of manifestation.

Vestibular migraine in multicenter neurology clinics according to the appendix criteria in the third beta edition of the International Classification of Headache Disorders

Cephalalgia ◽  
2015 ◽  
Vol 36 (5) ◽  
pp. 454-462 ◽  
Author(s):  
Soo-Jin Cho ◽  
Byung-Kun Kim ◽  
Byung-Su Kim ◽  
Jae-Moon Kim ◽  
Soo-Kyoung Kim ◽  
...  
Keyword(s):  
Headache Disorder ◽  
International Classification ◽  
Vestibular Migraine ◽  
Headache Disorders ◽  
The Third ◽  
Common Term ◽  
Vestibular Symptoms ◽  
The Common ◽  
Probable Migraine

Background Vestibular migraine (VM), the common term for recurrent vestibular symptoms with migraine features, has been recognized in the appendix criteria of the third beta edition of the International Classification of Headache Disorders (ICHD-3β). We applied the criteria for VM in a prospective, multicenter headache registry study. Methods Nine neurologists enrolled consecutive patients visiting outpatient clinics for headache. The presenting headache disorder and additional VM diagnoses were classified according to the ICHD-3β. The rates of patients diagnosed with VM and probable VM using consensus criteria were assessed. Results A total of 1414 patients were enrolled. Of 631 migraineurs, 65 were classified with VM (10.3%) and 16 with probable VM (2.5%). Accompanying migraine subtypes in VM were migraine without aura (66.2%), chronic migraine (29.2%), and migraine with aura (4.6%). Probable migraine (75%) was common in those with probable VM. The most common vestibular symptom was head motion-induced dizziness with nausea in VM and spontaneous vertigo in probable VM. The clinical characteristics of VM did not differ from those of migraine without VM. Conclusion We diagnosed VM in 10.3% of first-visit migraineurs in neurology clinics using the ICHD-3β. Applying the diagnosis of probable VM can increase the identification of VM.

International Classification of Headache Disorders 3rd edition beta-based field testing of vestibular migraine in China: Demographic, clinical characteristics, audiometric findings and diagnosis statues

Cephalalgia ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 240-248 ◽  
Author(s):  
Yixin Zhang ◽  
Qingtao Kong ◽  
Jinjin Chen ◽  
Lunxi Li ◽  
Dayan Wang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Cerebral Arteries ◽  
Field Testing ◽  
International Classification ◽  
Vestibular Migraine ◽  
Headache Disorders ◽  
Headache Clinic ◽  
Definition Of ◽  
Beta Version

Objectives This study explored the clinical characteristics of vestibular migraine in Chinese subjects and performed a field test of the criteria of the International Classification of Headache Disorders 3rd edition beta version. Methods Consecutive patients with vestibular migraine were surveyed and registered in a headache clinic during the study period. The diagnosis of vestibular migraine was made according to International Classification of Headache Disorders 3rd edition beta version. Assessments included standardized neuro-otology bedside examination, pure-tone audiogram, bithermal caloric testing, neurological imaging, cervical X-ray or magnetic resonance imaging, Doppler ultrasound of cerebral arteries and laboratory tests. Results A total of 67 patients (62 female/five male, 47.8 ± 10.3 years old) were enrolled in this study. The mean ages of migraine and vertigo onset were 32.2 ± 11.5 and 37.9 ± 10.1 years, respectively. The most common migraine subtype was migraine without aura (79%), followed by migraine with aura (12%) and chronic migraine (9%). The duration of vertigo attacks varied from seconds to days and 25% of patients had attacks that lasted less than 5 minutes. Among the patients with short-lasting attacks, 75% of these patients had ≥5 attacks per day within 72 hours. Auditory symptoms were reported in 36% of the patients. Migraine prophylactic treatments were effective in 77% of the patients. Conclusions Our study showed that the clinical features of vestibular migraine in China were similar to those of Western studies. The definition of vertigo episodes and migraine subtypes of vestibular migraine in International Classification of Headache Disorders 3rd edition beta version might be modified further. More than five vertigo attacks per day within 72 hours might be helpful as far as identifying vestibular migraine patients with short-lasting attacks.

Vestibular Migraine with Visual Aura and Olfactory Hallucination in Children: Two Case Reports

2018 ◽  
Vol 49 (06) ◽  
pp. 414-416 ◽  
Author(s):  
T.R. Villa ◽  
L.M. Agessi
Keyword(s):  
Case Reports ◽  
International Classification ◽  
Vestibular Migraine ◽  
Migraine Aura ◽  
Headache Disorders ◽  
Visual Aura ◽  
Clinical Description ◽  
Olfactory Hallucination

Background Approximately 3.9% children with migraine have olfactory hallucination which was defined as a perception of a smell without the substantial existence of any physical odor. Case We described the first two cases of children with vestibular migraine, presenting visual aura and olfactory hallucination. ​ We reported two children with vertigo, visual aura, and olfactory hallucination before the headache who were responsive to topiramate. Conclusion The clinical description of olfactory hallucination presented some characteristics of migraine aura. Olfactory hallucinations could be inserted as a migraine aura in International Classification of Headache Disorders.

Clinical Characteristics and Therapeutic Results in a Series of 68 Patients with Occipital Neuralgia

Pain Medicine ◽  
2019 ◽  
Author(s):  
Enrique Martínez-Pías ◽  
Javier Trigo-López ◽  
David García-Azorín ◽  
Aisling McGreal ◽  
Ángel Luis Guerrero Peral
Keyword(s):  
Clinical Characteristics ◽  
Negative Impact ◽  
International Headache Society ◽  
Tertiary Hospital ◽  
Occipital Neuralgia ◽  
Headache Disorders ◽  
Number Of Patients ◽  
Therapeutic Results ◽  
Prolonged Latency

Abstract Objective Cranial pain is a condition that has a negative impact on human lives, and occipital neuralgia is among its causes. This study aims to evaluate the clinical characteristics and therapeutic results of a series of patients with occipital neuralgia. Design Prospective registry (observational study). Settings Headache outpatient clinic in a tertiary hospital. Subjects Sixty-eight cases. Methods Demographic and nosological characteristics have been analyzed, as well as treatment response of occipital neuralgia. All patients were recruited between January 2008 and January 2018, and the diagnosis of occipital neuralgia was made according to the International Headache Society (International Classification of Headache Disorders) criteria being utilized at the time of diagnosis. Results Sixty-eight patients were diagnosed with occipital neuralgia, which corresponded to 1.2% of the total number of patients (5,515) who visited our Headache Unit during the aforementioned period. Fifty-four (79.4%) of them were female. Baseline pain was present in 62 (91.1%) patients, and exacerbations in 42 (61.8%). Latency from onset (range) was 27.7 ± 56.1 (1–360) months. Conclusions Occipital neuralgia is an uncommon disorder in the sample explored. The prolonged latency between the onset of symptoms and diagnosis suggests that there should be an increased awareness of this disorder.

Chronobiology differs between men and women with cluster headache, clinical phenotype does not

Neurology ◽  
2017 ◽  
Vol 88 (11) ◽  
pp. 1069-1076 ◽  
Author(s):  
Nunu Lund ◽  
Mads Barloese ◽  
Anja Petersen ◽  
Bryan Haddock ◽  
Rigmor Jensen
Keyword(s):  
Cluster Headache ◽  
Clinical Characteristics ◽  
Clinical Phenotype ◽  
Correct Diagnosis ◽  
Diagnostic Delay ◽  
Headache Disorders ◽  
Structured Interviews ◽  
Secondary Sector ◽  
Headache Center

Objective:To describe differences between the sexes in the phenotype of cluster headache (CH) in a large, well-characterized clinical CH population.Methods:Patients from the Danish CH survey aged 18–65 years, diagnosed with CH according to International Classification of Headache Disorders, second edition, completed questionnaires and structured interviews.Results:A total of 351 patients with CH participated, with a male:female ratio of 2:1. The diurnal variation of attacks showed moments of peak prominence in men’s attack cycle to be advanced by 1 hour compared to women’s, despite no difference in self-reported bedtime or chronotype (p = 0.31). The onset of CH decreased with increasing age for both sexes. Diagnostic delay was numerically longer for men vs women (6.56 vs 5.50 years, p = 0.21); however, more women had previously been misdiagnosed (61.1% vs 45.5%, p < 0.01) and received the correct diagnosis at a tertiary headache center (38.8% vs 20.9%, p < 0.001). Only minor sex differences in clinical characteristics were found but chronic CH was more prevalent in women compared to men (44.0% vs 31.9%, p < 0.05).Conclusions:Despite a similar clinical phenotype, diurnal attack cycle is advanced by 1 hour in men with CH compared to women. Rhythmicity is a defining characteristic of CH and these findings suggest differences in the hypothalamus’ influence on attack occurrence between the sexes. In addition, women were more often misdiagnosed and diagnosis in the primary or secondary sector more often failed. Furthermore, women had chronic CH more frequently than men. A long diagnostic delay and frequent misdiagnosis emphasize the need for increased awareness of CH in both sexes.

scholarly journals Menstrual versus non-menstrual attacks of migraine without aura in women with and without menstrual migraine

Cephalalgia ◽  
2015 ◽  
Vol 35 (14) ◽  
pp. 1261-1268 ◽  
Author(s):  
Kjersti Grøtta Vetvik ◽  
Jūratė Šaltytė Benth ◽  
E Anne MacGregor ◽  
Christofer Lundqvist ◽  
Michael Bjørn Russell
Keyword(s):  
General Population ◽  
Migraine Without Aura ◽  
Clinical Characteristics ◽  
Repeated Measurements ◽  
Menstrual Migraine ◽  
Headache Disorders ◽  
Severe Nausea ◽  
Menstrual Cycles ◽  
Headache Diary

Objective The objective of this article is to compare clinical characteristics of menstrual and non-menstrual attacks of migraine without aura (MO), prospectively recorded in a headache diary, by women with and without a diagnosis of menstrual migraine without aura (MM) according to the International Classification of Headache Disorders (ICHD). Material and methods A total of 237 women from the general population with self-reported migraine in ≥50% of their menstrual periods were interviewed and classified by a physician according to the criteria of the ICHD II. Subsequently, all participants were instructed to complete a prospective headache diary for at least three menstrual cycles. Clinical characteristics of menstrual and non-menstrual attacks of MO were compared by a regression model for repeated measurements. Results In total, 123 (52%) women completed the diary. In the 56 women who were prospectively diagnosed with MM by diary, the menstrual MO-attacks were longer (on average 10.65 hours, 99% CI 3.17–18.12) and more frequently accompanied by severe nausea (OR 2.14, 99% CI 1.20–3.84) than non-menstrual MO-attacks. No significant differences between menstrual and non-menstrual MO-attacks were found among women with MO, but no MM. Conclusion In women from the general population, menstrual MO-attacks differ from non-menstrual attacks only in women who fulfil the ICHD criteria for MM.

VESTIBULAR MIGRAINE-UPDATES AND CHALLENGES: REVIEW OF LITERATURE

2021 ◽  
pp. 1-5
Author(s):  
Aravind Varma Datla ◽  
Sibasankar Dalai
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Criteria ◽  
Clinical Characteristics ◽  
Vestibular Migraine ◽  
Review Of Literature ◽  
Headache Disorders ◽  
Classi Cation

Complaints of dizziness or vertigo entirely are common in patients with migraines, at least occasionally. Vestibular migraine was recently integrated as an independent article in the International Classication of Headache Disorders 3-beta appendix. Despite this, it is still an underdiagnosed condition. The exact mechanism of vestibular migraine is still unclear. This review presents an overview of the history, epidemiology, pathophysiology, clinical characteristics, diagnostic criteria, differential diagnosis and the treatment of VM.

Differences in characteristics between definite vestibular migraines, migraines with vestibular symptoms that do not meet vestibular migraine criteria, and migraines without vestibular symptoms: A cross-sectional study through the lens of central sensitization

2021 ◽  
Author(s):  
Toshihide Toriyama ◽  
Yoshiki Hanaoka ◽  
Tetsuyoshi Horiuchi
Keyword(s):  
Central Sensitization ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Disease Process ◽  
Cross Sectional Study ◽  
Tender Point ◽  
Vestibular Migraine ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vestibular Symptoms

Abstract Background: The demographic and clinical characteristics of vestibular migraine (VM) based on the International Classification of Headache Disorders (ICHD)-III beta are not well documented, and the underlying pathophysiology remains largely unknown. Based on evidence that central sensitization is involved in VM pathogenesis, we hypothesized that cutaneous allodynia (CA), which is a clinical manifestation of central sensitization, and interictal widespread pressure hyperalgesia (IWPH), which may be an accelerator for central sensitization, are more frequently associated with VM patients compared with non-VM patients. The aim of this study was as follows: 1) to assess differences in demographic and clinical characteristics among VM patients, patients with migraine with vestibular symptoms not meeting VM criteria (MwVS), and patients with migraine without vestibular symptoms (MwoVS); and 2) to evaluate whether VM patients were more frequently associated with CA/IWPH compared with the other two groups.Methods: This cross-sectional study enrolled consecutive migraine patients, aged 18–65. The comprehensive interview form included diagnostic questions of migraine and VM, demographic characteristics, migraine-specific variables, migraine-associated symptoms, and CA. IWPH occurrence was investigated using a manual tender point survey and clinical parameters were compared.Results: A total of 245 episodic migraineurs (mean age = 39.5 ± 11.3 years, 81.2% women) were enrolled. Based on ICHD-III beta criteria, 65 (26.5%), 74 (30.2%), and 106 (43.3%) patients were assigned to the VM group, MwVS group, or MwoVS group, respectively. Pairwise comparisons demonstrated no significant differences between the VM and MwVS groups, except for higher occurrence of headache disability in the VM group. Compared with the MwoVS group, the VM group was significantly associated with aura, severe disability, depression, tinnitus, sleep disorders, multimodal CA, and IWPH.Conclusions: There were no significant differences in clinical features between VM and MwVS groups, except for disability, which was possibly caused by criteria selection bias. VM and MwVS may be on the same disease process spectrum. Widespread multimodal CA, including clinical manifestations of thalamic sensitization, was significantly associated with VM patients compared with MwoVS patients, which indicates that thalamic sensitization may play a key role VM pathogenesis. Furthermore, IWPH may enhance susceptibility to thalamic sensitization.

scholarly journals Grey Zones in the Diagnosis of Adult Migraine without Aura Based on the International Classification of Headache Disorders-Iii Beta: Exploring the Covariates of Possible Migraine without Aura

2015 ◽  
Vol 20 (1) ◽  
pp. e1-e7 ◽  
Author(s):  
Aynur Ozge ◽  
Elif Aydinlar ◽  
Bahar Tasdelen
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Criteria ◽  
Motion Sickness ◽  
Migraine Without Aura ◽  
Clinical Characteristics ◽  
Diagnostic Value ◽  
Infantile Colic ◽  
Headache Disorders ◽  
Final Version

BACKGROUND: Exploring clinical characteristics and migraine covariates may be useful in the diagnosis of migraine without aura.OBJECTIVE: To evaluate the diagnostic value of the International Classification of Headache Disorders (ICHD)-III beta-based diagnosis of migraine without aura; to explore the covariates of possible migraine without aura using an analysis of grey zones in this area; and, finally, to make suggestions for the final version of the ICHD-III.METHODS: A total of 1365 patients (mean [± SD] age 38.5±10.4 years, 82.8% female) diagnosed with migraine without aura according to the criteria of the ICHD-III beta were included in the present tertiary care-based retrospective study. Patients meeting all of the criteria of the ICHD-III beta were classified as having full migraine without aura, while those who did not meet one, two or ≥3 of the diagnostic criteria were classified as zones I, II and III, respectively. The diagnostic value of the clinical characteristics and covariates of migraine were determined.RESULTS: Full migraine without aura was evident in 25.7% of the migraineurs. A higher likelihood of zone I classification was shown for an attack lasting 4 h to 72 h (OR 1.560; P=0.002), with pulsating quality (OR 4.096; P<0.001), concomitant nausea/vomiting (OR 2.300; P<0.001) and photophobia/phonophobia (OR 4.865; P<0.001). The first-rank determinants for full migraine without aura were sleep irregularities (OR 1.596; P=0.005) and periodic vomiting (OR 1.464; P=0.026). However, even if not mentioned in ICHD-III beta, the authors determined that motion sickness, abdominal pain or infantile colic attacks in childhood, associated dizziness and osmophobia have important diagnostic value.CONCLUSIONS: In cases that do not fulfill all of the diagnostic criteria although they are largely consistent with the characteristics of migraine in clinical terms, the authors believe that a history of infantile colic; periodic vomiting (but not periodic vomiting syndrome); recurrent abdominal pain; the presence of motion sickness or vertigo, dizziness or osmophobia accompanying the pain; and comorbid atopic disorder are characteristics that should to be discussed and considered as additional diagnostic criteria (covariates) in the preparation of the final version of ICHD-III.

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