Vestibular migraine: epidemiology, pathogenesis, clinical picture, diagnosis and treatment
https://doi.org/10.14412/2074-2711-2022-6-4-11
Abstract
The epidemiology of vestibular migraine (VM), which is the most common cause of episodic dizziness, is discussed. The pathogenesis schematic is discussed, the key feature of which is the disturbance of the interaction of trigemino-vascular system, nociceptive centers of the brain stem, thalamocortical networks and the vestibular system. The clinical picture of the disease is presented in the form of spontaneous, positional, visually induced and head movement-induced dizziness, cochlear and other symptoms. The relation of vestibular symptoms and headache was analyzed. The data of neurological and vestibular examination are reflected, the features of positional nystagmus are considered in detail. The diagnostic criteria of the disease are presented. Approaches to VM attacks relief and prevention are considered.
About the Authors
A. A. Kulesh
Department of neurology and medical genetics, Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
Aleksey Aleksandrovich Kulesh
614990, Perm, Petropavlovskaya St., 26
Competing Interests:
There are no conflicts of interest.
V. A. Parfenov
Department of Nervous Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Competing Interests:
Russian Federation
119021, Moscow, Rossolimo St., 11, Build. 1
Competing Interests:
There are no conflicts of interest.
References
1. Parfenov VA, Zamergrad MV, Melnikov OA. Golovokruzheniye: diagnostika i lecheniye, rasprostranennyye diagnosticheskiye oshibki [Dizziness: diagnosis and treatment, common diagnostic errors]. 3rd ed. Moscow: MIA; 2019. 208 c. Available from: https://medknigaservis.ru/product/golovokruzhenie-diagnostika-i-lechenie-rasprostranennye-diagnosticheskie-oshibki (In Russ.).
2. Parfenov VA, Kulesh AA, Demin DA, et al. Vestibular vertigo in stroke and vestibular neuronitis. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2021;121(12-2):41-9. doi:10.17116/jnevro202112112241 (In Russ.).
3. Kulesh AA, Dyomin DA, Guseva AL, et al. Vestibular vertigo in emergency neurology. Rossiyskiy nevrologicheskiy zhurnal = Russian Neurological Journal. 2021;26(4):50-9. doi:10.30629/2658-7947-2021-26-4-50-59 (In Russ.).
4. Dieterich M, Brandt T. Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol. 1999 Oct;246(10):883-92. doi:10.1007/s004150050478
5. Neuhauser H, Leopold M, von Brevern M, et al. The interrelations of migraine, vertigo, and migrainous vertigo. Neurology. 2001 Feb 27;56(4):436-41. doi:10.1212/wnl.56.4.436
6. Teggi R, Colombo B, Albera R, et al. Clinical Features, Familial History, and Migraine Precursors in Patients with Definite Vestibular Migraine: The VMPhenotypes Projects. Headache. 2018 Apr;58(4):534-44. doi:10.1111/head.13240
7. Lempert T, von Brevern M. Vestibular Migraine. Neurol Clin. 2019 Nov;37(4):695-706. doi:10.1016/j.ncl.2019.06.003
8. Baloh RW. Vestibular Migraine I: Mechanisms, Diagnosis, and Clinical Features. Semin Neurol. 2020 Feb;40(1):76-82. doi:10.1055/s-0039-3402735
9. Lempert T, Olesen J, Furman J, et al. Vestibular migraine: diagnostic criteria. J Vestib Res. 2012;22(4):167-72. doi:10.3233/VES2012-0453
10. Lempert T, Olesen J, Furman J, et al. Vestibular migraine: Diagnostic criteria1. J Vestib Res. 2022;32(1):1-6. doi:10.3233/VES-201644
11. Huang TC, Wang SJ, Kheradmand A. Vestibular migraine: An update on current understanding and future directions. Cephalalgia. 2020 Jan;40(1):107-21. doi:10.1177/0333102419869317
12. Neuhauser HK. The epidemiology of dizziness and vertigo. Handb Clin Neurol. 2016;137:67-82. doi:10.1016/B978-0-444-63437-5.00005-4
13. Cho SJ, Kim BK, Kim BS, et al. Vestibular migraine in multicenter neurology clinics according to the appendix criteria in the third beta edition of the International Classification of Headache Disorders. Cephalalgia. 2016 Apr;36(5):454-62. doi:10.1177/0333102415597890
14. Chechet EA, Parfenov VA. Vestibular migraine in a patient with chronic tension headache, medication overuse headache and anxiety disorders. Nevrologicheskiy zhurnal = The Neurological Journal. 2017;22(2):97-104 doi:10.18821/1560-9545-2017-22-2-97-104 (In Russ.).
15. Li AV, Parkhomenko EV, Barinov AN. Vestibular migraine: diagnostic difficulties and treatment optimization. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2017;117(8):59-66. doi:10.17116/jnevro20171178159-66 (In Russ.).
16. Dieterich M, Obermann M, Celebisoy N. Vestibular migraine: the most frequent entity of episodic vertigo. J Neurol. 2016 Apr;263 Suppl 1:S82-9. doi:10.1007/s00415-015-7905-2
17. Formeister EJ, Rizk HG, Kohn MA, Sharon JD. The Epidemiology of Vestibular Migraine: A Population-based Survey Study. Otol Neurotol. 2018 Sep;39(8):1037-44. doi:10.1097/MAO.0000000000001900
18. Von Brevern M, Radtke A, Lezius F, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007 Jul;78(7):710-5. doi:10.1136/jnnp.2006.100420
19. Kim MH, Cheon C. Epidemiology and Seasonal Variation of Meniere's Disease: Data from a Population-Based Study. Audiol Neurootol. 2020;25(4):224-30. doi:10.1159/000506921
20. Hsu LC, Wang SJ, Fuh JL. Prevalence and impact of migrainous vertigo in mid-life women: a community-based study. Cephalalgia. 2011 Jan;31(1):77-83. doi:10.1177/0333102410373152
21. Antonenko LM, Parfenov VA. Vestibular vertigo. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2020;120(6):125-30. doi:10.17116/jnevro2020120061125 (In Russ.).
22. Yollu U, Uluduz DU, Yilmaz M, et al. Vestibular migraine screening in a migrainediagnosed patient population, and assessment of vestibulocochlear function. Clin Otolaryngol. 2017 Apr;42(2):225-33. doi:10.1111/coa.12699
23. Cha YH, Lee H, Santell LS, Baloh RW. Association of benign recurrent vertigo and migraine in 208 patients. Cephalalgia. 2009 May;29(5):550-5. doi:10.1111/j.1468-2982.2008.01770.x
24. Beh SC, Masrour S, Smith SV, Friedman DI. The Spectrum of Vestibular Migraine: Clinical Features, Triggers, and Examination Findings. Headache. 2019 May;59(5):727-40. doi:10.1111/head.13484
25. Teggi R, Colombo B, Albera R, et al. Clinical Features of Headache in Patients With Diagnosis of Definite Vestibular Migraine: The VM-Phenotypes Projects. Front Neurol. 2018 Jun 5;9:395. doi:10.3389/fneur.2018.00395
26. Celebisoy N, Kisabay Ak A, Еzdemir HN, et al. Vestibular migraine, demographic and clinical features of 415 patients: A multicenter study. Clin Neurol Neurosurg. 2022 Apr;215:107201. doi:10.1016/j.clineuro.2022.107201
27. Özcelik P, Kocoglu K, Öztürk V, et al. Characteristic differences between vestibular migraine and migraine only patients. J Neurol. 2022 Jan;269(1):336-41. doi:10.1007/s00415-021-10636-0
28. Mallampalli MP, Rizk HG, Kheradmand A, et al. Care Gaps and Recommendations in Vestibular Migraine: An Expert Panel Summit. Front Neurol. 2022 Jan 3;12:812678. doi:10.3389/fneur.2021.812678
29. Klein A, Schankin CJ. Visual snow syndrome, the spectrum of perceptual disorders, and migraine as a common risk factor: A narrative review. Headache. 2021 Oct;61(9):1306-13. doi:10.1111/head.14213
30. Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE. Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res. 2009;19(1-2):1-13. doi:10.3233/VES-2009-0343
31. Young AS, Nham B, Bradshaw AP, et al. Clinical, oculographic, and vestibular test characteristics of vestibular migraine. Cephalalgia. 2021 Sep;41(10):1039-52. doi:10.1177/03331024211006042
32. Von Brevern M, Zeise D, Neuhauser H, et al. Acute migrainous vertigo: clinical and oculographic findings. Brain. 2005 Feb;128(Pt 2):365-74. doi:10.1093/brain/awh351
33. Chen CC, Wang CY, Chen PY, et al. Clinical Spectrum of Positional Vertigo in an Outpatient Setting. Ear Hear. 2022 Jul-Aug 01;43(4):1256-61. doi:10.1097/AUD.0000000000001177
34. Bruss D, Abouzari M, Sarna B, et al. Migraine Features in Patients With Recurrent Benign Paroxysmal Positional Vertigo. Otol Neurotol. 2021 Mar 1;42(3):461-5. doi:10.1097/MAO.0000000000002976
35. Si L, Shen B, Li Y, et al. Clinical Characteristics of Patients with Persistent Apogeotropic and Persistent Geotropic Direction-Changing Positional Nystagmus. J Clin Neurol. 2021 Jul;17(3):443-54. doi:10.3988/jcn.2021.17.3.443
36. Bedenko AS, Antonenko LM. Metabolic disorders in patients with vestibular migraine. Epilepsiya i paroksizmal'nyye sostoyaniya = Epilepsy and Paroxysmal Conditions. 2021;13(4):359-66. doi:10.17749/2077-8333/epi.par.con.2021.094 (In Russ.).
37. Murdin L, Chamberlain F, Cheema S, et al. Motion sickness in migraine and vestibular disorders. J Neurol Neurosurg Psychiatry. 2015 May;86(5):585-7. doi:10.1136/jnnp-2014-308331
38. Gassieva DM, Zamergrad MV, Tabeeva GR. Association between migraine and vestibular disorders. Epilepsiya i paroksizmal'nyye sostoyaniya = Epilepsy and Paroxysmal Conditions. 2019;11(1):88-96. doi:10.17749/2077-8333.2019.11.1.88-96 (In Russ.).
39. Wattiez AS, O'Shea SA, Ten Eyck P, et al. Patients with Vestibular Migraine are More Likely to Have Occipital Headaches than those With Migraine Without Vestibular Symptoms. Headache. 2020 Sep;60(8):1581-91. doi:10.1111/head.13898
40. Yan M, Guo X, Liu W, et al. Temporal Patterns of Vertigo and Migraine in Vestibular Migraine. Front Neurosci. 2020 Apr 15;14:341. doi:10.3389/fnins.2020.00341
41. Neff BA, Staab JP, Eggers SD, et al. Auditory and vestibular symptoms and chronic subjective dizziness in patients with Meniere's disease, vestibular migraine, and Meniere's disease with concomitant vestibular migraine. Otol Neurotol. 2012 Sep;33(7):1235-44. doi:10.1097/MAO.0b013e31825d644a
42. Tabet P, Saliba I. Meniere's Disease and Vestibular Migraine: Updates and Review of the Literature. J Clin Med Res. 2017 Sep;9(9):733-44. doi:10.14740/jocmr3126w. Epub 2017 Jul 27.
43. Radtke A, von Brevern M, Neuhauser H, et al. Vestibular migraine: long-term follow-up of clinical symptoms and vestibulo-cochlear findings. Neurology. 2012 Oct 9;79(15):1607-14. doi:10.1212/WNL.0b013e31826e264f
44. Perez-Carpena P, Lopez-Escamez JA. Do we need to reconsider the classification of vestibular migraine? Expert Rev Neurother. 2021 May;21(5):503-16. doi:10.1080/14737175.2021
45. Chen WH, Hsu YL, Chen YS, Yin HL. Clocking tinnitus: An audiology symptom of migraine. Clin Neurol Neurosurg. 2019 Feb;177:73-6. doi:10.1016/j.clineuro.2019.01.001
46. Polensek SH, Tusa RJ. Nystagmus during attacks of vestibular migraine: an aid in diagnosis. Audiol Neurootol. 2010;15(4):241-6. doi:10.1159/000255440
47. Lechner C, Taylor RL, Todd C, et al. Causes and characteristics of horizontal positional nystagmus. J Neurol. 2014 May;261(5):1009-17. doi:10.1007/s00415-013-7223-5
48. Yu J, Yu Q, Guan B, et al. Pseudo-Benign Paroxysmal Positional Vertigo: A Retrospective Study and Case Report. Front Neurol. 2020 Mar 24;11:187. doi:10.3389/fneur.2020.00187
49. Carmona S, Zalazar GJ, Fernandez M, et al. Atypical Positional Vertigo: Definition, Causes, and Mechanisms. Audiol Res. 2022 Mar 14;12(2):152-61. doi:10.3390/audiolres12020018
50. The International Classification of Headache Disorders. 3rd ed. Available from: https://ichd-3.org/ (accessed 11.27.2020).
51. Chae R, Krauter R, Pasquesi LL, Sharon JD. Broadening the vestibular migraine diagnosis criteria: A prospective cohort study on vestibular migraine subtypes. J Vestib Res. 2022 Feb 2. doi:10.3233/VES-210117
52. Antonenko LM, Parfenov VA. Drug therapy for peripheral vestibular vertigo. Nevrologiya, neyropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2017;9(1):106-10. doi:10.14412/2074-2711-2017-1-106-110 (In Russ.).
53. Zamergrad MV, Morozova SV. Modern approaches to drug treatment for vestibular vertigo. Nevrologiya, neyropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(1):101-6. doi:10.14412/2074-2711-2021-1-101-106 (In Russ.).
54. Neuhauser H, Radtke A, von Brevern M, Lempert T. Zolmitriptan for treatment of migrainous vertigo: a pilot randomized placebo-controlled trial. Neurology. 2003 Mar 11;60(5):882-3. doi:10.1212/01.wnl.0000049476.40047.a3
55. Furman JM, Marcus DA, Balaban CD. Rizatriptan reduces vestibular-induced motion sickness in migraineurs. J Headache Pain. 2011 Feb;12(1):81-8. doi:10.1007/s10194-010-0250-z
56. Cassano D, Pizza V, Busillo V. P074. Almotriptan in the acute treatment of Vestibular migraine: a retrospective study. J Headache Pain. 2015 Dec;16(Suppl 1):A114. doi:10.1186/1129-2377-16-S1-A114
57. Prakash S, Shah ND. Migrainous vertigo responsive to intravenous methylprednisolone: case reports. Headache. 2009 Sep;49(8):1235-9. doi:10.1111/j.1526-4610.2009.01474.x
58. Baron EP, Cherian N, Tepper SJ. Role of greater occipital nerve blocks and trigger point injections for patients with dizziness and headache. Neurologist. 2011 Nov;17(6):312-7. doi:10.1097/NRL.0b013e318234e966
59. Beh SC. Nystagmus and Vertigo in Acute Vestibular Migraine Attacks: Response to NonInvasive Vagus Nerve Stimulation. Otol Neurotol. 2021 Feb 1;42(2):e233-e236. doi:10.1097/MAO.0000000000002892
60. Roberts RA, Watford KE, Picou EM, et al. Effects of Lifestyle Modification on Vestibular Migraine. Otol Neurotol. 2021 Dec 1;42(10):e1537-e1543. doi:10.1097/MAO.0000000000003297
61. Li M, Xu X, Qi W, et al. Vestibular migraine: the chameleon in vestibular disease. Neurol Sci. 2021 May;42(5):1719-31. doi:10.1007/s10072-021-05133-1
62. Balci B, Akdal G. Outcome of vestibular rehabilitation in vestibular migraine. J Neurol. 2022 Jul 8. doi:10.1007/s00415-022-11250-4
63. Antonenko LM, Parfenov VA. Rehabilitation of patients with vestibular disorders. Meditsinskiy sovet = Medical Council. 2017;(1S):33-7. doi:10.21518/2079-701X2017-0-33-37 (In Russ.).
64. Von Brevern M, Lempert T. Vestibular Migraine: Treatment and Prognosis. Semin Neurol. 2020 Feb;40(1):83-6. doi:10.1055/s0039-3402067
65. Celebisoy N, Gökcay F, Karahan C, et al. Acetazolamide in vestibular migraine prophylaxis: a retrospective study. Eur Arch Otorhinolaryngol. 2016 Oct;273(10):2947-51. doi:10.1007/s00405-015-3874-4
66. Li G, Xu J, Zhou X, Wu S, Yin Y, Zhuang J, Li F. [The efficacy of topiramate and flunarizine hydrochloride for prophylactic treatment of vestibular migraine]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Sep;35(9):784-7;795. doi:10.13201/j.issn.2096-7993.2021.09.004 (In Chinese).
67. Rashid SMU, Sumaria S, Koohi N, et al. Patient Experience of Flunarizine for Vestibular Migraine: Single Centre Observational Study. Brain Sci. 2022 Mar 22;12(4):415. doi:10.3390/brainsci12040415
68. Wang F, Wang J, Cao Y, Xu Z. Serotoninnorepinephrine reuptake inhibitors for the prevention of migraine and vestibular migraine: a systematic review and meta-analysis. Reg Anesth Pain Med. 2020 May;45(5):323-30. doi:10.1136/rapm-2019-101207
69. Görür K, Gür H, Ismi O, et al. The effectiveness of propranolol, flunarizine, amitriptyline and botulinum toxin in vestibular migraine complaints and prophylaxis: a non-randomized controlled study. Braz J Otorhinolaryngol. 2022 Nov-Dec;88(6):975-81. doi:10.1016/j.bjorl.2021.02.005. Epub 2021 Mar 7.
70. Byun YJ, Levy DA, Nguyen SA, et al. Treatment of Vestibular Migraine: A Systematic Review and Meta-analysis. Laryngoscope. 2021 Jan;131(1):186-94. doi:10.1002/lary.28546
71. Hoskin JL, Fife TD. New Anti-CGRP Medications in the Treatment of Vestibular Migraine. Front Neurol. 2022 Jan 27;12:799002. doi:10.3389/fneur.2021.799002
72. Liu F, Ma T, Che X, et al. The Efficacy of Venlafaxine, Flunarizine, and Valproic Acid in the Prophylaxis of Vestibular Migraine. Front Neurol. 2017 Oct 11;8:524. doi:10.3389/fneur.2017.00524
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For citations:
Kulesh AA, Parfenov VA. Vestibular migraine: epidemiology, pathogenesis, clinical picture, diagnosis and treatment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2022;14(6):4-11. (In Russ.) https://doi.org/10.14412/2074-2711-2022-6-4-11
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