Static Subjective Visual Vertical (SVV) in Patients with Vestibular Migraine

Area of Science:

• Neuroscience
• Ophthalmology
• Otolaryngology

Background:

• Vestibular migraine (VM) is a frequent cause of episodic dizziness, often underdiagnosed and poorly understood.
• Impaired otolith reflex pathway performance is suspected in VM patients, affecting roll plane stimulus perception.
• Subjective visual vertical (SVV) testing is a clinical tool to assess this perception.

Purpose of the Study:

• To compare static SVV performance in VM patients against normative data.
• To analyze absolute mean SVV tilt and response variance in VM patients.

Main Methods:

• Retrospective case review of 94 VM patients (18-65 years old).
• Documentation of demographic data, symptoms, and vestibular laboratory results.
• SVV performance assessed via absolute mean SVV tilt and response variance.

Main Results:

• 54% of VM patients exhibited abnormal mean SVV tilt.
• Abnormalities in SVV tilt or variance were found in 67% of patients.
• Abnormal ocular vestibular myogenic potential results correlated with abnormal SVV and utriculo-ocular reflex performance.

Conclusions:

• Abnormalities in SVV tilt and variance are common in Vestibular Migraine.
• Findings support theories of atypical intralabyrinthine integration in vestibular nuclei and cerebellar pathways.