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Published on: June 2, 2014
Benign paroxysmal positional vertigo and migraine: analysis of 186 cases
Objective:
This retrospective study assessed several clinical, case history and functional parameters to investigate benign paroxysmal positional vertigo (BPPV) in patients with migraine.
Methods:
Two groups of patients were compared: those affected by BPPV and migraine (group A), as defined by International Headache Society criteria, and those with BPPV without migraine or with another form of headache (group B). The following parameters were investigated: onset of BPPV, recovery time, residual dizziness, recurrence of BPPV, atypical eye movement patterns and Meniere-like vertigo in the inter-critical BPPV period.
Results:
Mean age at BPPV onset was 39 years +/- 9.2 in Group A and 53 years +/- 7.3 in Group B (p = 0.00). No significant difference emerged in the number of manoeuvres needed to achieve recovery (Group A: 1.7 +/- 0.94; Group B: 1.9 +/- 0.89; p > 0.05). Highly recurrent BPPV (at least 4 documented episodes) was observed in 15 patients from group A (19.4%) and in 8 patients from group B (7.3%). Atypical eyes movements and Meniere-like vertigo were more frequent in migraineurs with highly recurrent BPPV (Chi square = 5.76; p < 0.016).
Conclusions:
A high prevalence of BPPV and earlier onset in migraine are the main findings of this study. There is a higher incidence of a range of neurotological patterns in the intervals between BPPV episodes in migraineurs with recurrent vertigo. No direct pathophysiological link between migraine and BPPV has yet been established; comorbidity seems to affect clinical features in a sub-population of patients and make BPPV more debilitating.
Insights
Migraine patients experience benign paroxysmal positional vertigo (BPPV) earlier and more frequently. This comorbidity can make BPPV more debilitating, with increased neurotological symptoms between vertigo episodes.
Area of Science:
- Neurology
- Otolaryngology
- Neurotology
Background:
- Benign paroxysmal positional vertigo (BPPV) is a common inner ear disorder.
- Migraine is a prevalent neurological condition with complex mechanisms.
- The relationship between BPPV and migraine requires further investigation.
Purpose of the Study:
- To investigate clinical, historical, and functional parameters of BPPV in patients with and without migraine.
- To compare the onset, recovery, recurrence, and associated symptoms of BPPV in migraineurs versus non-migraineurs.
Main Methods:
- Retrospective study comparing two groups: BPPV with migraine (Group A) and BPPV without migraine (Group B).
- Analysis of BPPV onset age, recovery time, residual dizziness, recurrence rates, atypical eye movements, and Meniere-like vertigo.
- International Headache Society criteria used for migraine diagnosis.
Main Results:
- Mean age at BPPV onset was significantly lower in Group A (39 years) compared to Group B (53 years).
- Highly recurrent BPPV (≥4 episodes) was more frequent in Group A (19.4%) than in Group B (7.3%).
- Atypical eye movements and Meniere-like vertigo were more common in migraineurs with recurrent BPPV.
Conclusions:
- Migraine is associated with an earlier onset and higher prevalence of BPPV.
- Comorbidity of migraine and BPPV can lead to more debilitating BPPV with increased neurotological symptoms.
- No direct pathophysiological link is established, but comorbidity influences clinical presentation and severity.
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