Migraine and vertigo are common disorders, affecting about 14% and 10%, respectively, of the general population. If migraine and vertigo were unrelated, the expected comorbidity would be 1%, whereas recent epidemiological studies indicate that 3.2% of the population have both migraine and vertigo. The excess comorbidity may be attributed to two factors: 1) vertigo syndromes (including Menière's disease, benign paroxysmal positional vertigo, and anxiety-related dizziness) that are more common in migraineurs than in controls and 2) vestibular migraine (VM) (vertigo as a symptom of migraine.) VM presents with attacks of spontaneous or positional vertigo lasting seconds to days. Headaches are often absent during acute attacks, but other migrainous features such as photophobia or auras, may be present. Like migraine headaches, VM triggers include stress, sleep deprivation, and hormonal changes. During acute attacks, there may be central spontaneous or positional nystagmus and, less commonly, unilateral vestibular hypofunction. In the symptom-free interval, vestibular testing shows mostly minor and nonspecific findings. The pathogenesis of VM is uncertain, but migraine mechanisms may interfere with the vestibular system at the labyrinth, brainstem, and cerebral cortex. Treatment includes vestibular suppressants for acute attacks and migraine prophylaxis for patients with frequent recurrences. However, treatment efficacy has not been validated by properly controlled clinical trials. VM does not fit into the 2004 International Headache Society Classification, in which "basilar-type migraine" must have at least two posterior circulation manifestations; isolated vertigo would not satisfy this criterion.
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http://dx.doi.org/10.1111/j.1749-6632.2009.03852.x | DOI Listing |
Laryngoscope
December 2024
Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Purpose: This study aims to investigate whether artificial intelligence can improve the diagnostic accuracy of vertigo related diseases.
Experimental Design: Based on the clinical guidelines, clinical symptoms and laboratory test results were extracted from electronic medical records as variables. These variables were then input into a machine learning diagnostic model for classification and diagnosis.
Otolaryngol Head Neck Surg
December 2024
Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Introduction: The Efferent Vestibular System (EVS) originates in brainstem Efferent Vestibular Nuclei (EVN) and modifies afferent vestibular signals at their source, in peripheral vestibular organs. Recent evidence suggests that EVS is also involved in the development of motion sickness symptoms, including vertigo and nausea, but the underlying mechanism is unknown. One possible link between EVN and motion sickness symptoms is through the neuropeptide calcitonin gene-related peptide (CGRP).
View Article and Find Full Text PDFClin Otolaryngol
December 2024
Department of Otorhinolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Objectives: The first purpose of this study was to ascertain the distribution of unilateral Ménière's disease (MD) clinical subgroups in China and compare with the population reported in Europe and the United States. The second purpose was to investigate the effectiveness in different clinical phenotypes.
Methods: Participants were categorised into one of five subtypes using a previously reported classification scheme based on cluster analysis.
Otol Neurotol
January 2025
Department of Otolaryngology-Head and Neck Surgery.
Objective: To evaluate the levels of inflammatory cytokines and symptom survey scores in patients diagnosed with Menière's disease or vestibular migraine from a single center by a single neurotologist compared to control subjects with no history of dizziness or migraine.
Study Design: Cross-sectional pilot study.
Setting: Single-center tertiary referral center in Charleston, SC.
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