Cutaneous Allodynia and Photophobia in Vestibular Migraine and Other Vestibular Disorders: A Prospective Study in a Tertiary Centre.

Introduction: Photophobia (PP) and cutaneous allodynia (CA) are sensory sensitivity symptoms recognised as features of migraine. The prevalence of PP and CA in vestibular migraine (VM) and other vestibular disorders (OVD) is unknown.

Aim: The aim of this study is to measure the prevalence of PP and CA in VM compared with OVD.

Methodology: Consecutive patients in a dizziness clinic were classified as either VM or OVD. Patients with chronic migraine with VM (VMCM) and without VM (NVCM) presenting to a tertiary headache clinic were included. All completed validated questionnaires: Leiden Visual Sensitivity Scale (L-VISS) for PP and Allodynia Symptom Checklist (ASC-12) for CA.

Results: Ninety participants provided responses (age 23-82 years; 71 females and 19 males; 27 with VM, 21 with VMCM, 19 with NVCM and 23 with OVD). The PP mean scores were similar between VM, VMCM and NVCM, and higher in those three groups compared to OVD (ANOVA, p < 0.0005). The mean rank for CA was higher in those three groups compared to OVD (Kruskal-Wallis, p < 0.05), but not significantly different with other group combinations. CA was much more specific for VM, VMCM and NVCM (83%) compared to 4% for PP. The odds of VMCM, NVCM and VM patients having CA were 99.353, 47.595 and 16.708 times that for OVD, respectively (ordinal logistic regression, p < 0.005).

Conclusion: VM can be distinguished from OVD by ASC-12 and L-VISS questionnaires with high specificity for CA. CA might be an under-recognised symptom of VM.