Clinical features of vestibular migraine in Egypt

BackgroundMany reports have documented a relationship between vestibular and migraine disorders. The term vestibular migraine appeared in an appendix of the third edition of IHS as a first step for new entities (Neuhauser et al., 2001).ObjectiveTo determine the prevalence of vestibular migraine in a dizziness clinic and to describe its clinical profile.MethodsRetrospective study was conducted in the period from January 2011 to December 2013. Charts of patients coming for Hearing and Balance Clinic were thoroughly reviewed. Patients fulfilling criteria of definite VM according to The International Classification of Headache Disorders, 3rd edition (beta version) were selected. A full neuro-otologic evaluation and Videonystagmography with bithermal caloric testing were included in their files and were analyzed.ResultsThe prevalence of vestibular migraine in a dizziness clinic was found to be 22%. Vertigo either isolated or combined with the sense of imbalance was found in over 60%. Phonophobia was the commonest aural symptom, followed by the sense of bilateral ear fullness and tinnitus. Positional nystagmus was frequently recorded in 60% of the patients. Caloric weakness was seldom seen (7.5%). Hearing loss was encountered in only 3.1%. None of the patients demonstrated abnormalities in ocular motor tests. History of motion sickness was highly statistically correlated to the presence of VNG abnormalities.ConclusionsVestibular migraine is one of the leading causes of dizziness in both adults and children. A high percentage of patients showed abnormalities in Videonystagmography during testing documenting vestibular system involvement in migraine patients during the dizziness attack. Good history taking and analysis of aural symptoms helps in the differential diagnosis. The profile of VM patients is outlined.