Clinical Profile of Vestibular Migraine- Insights from a Retrospective Study

Vestibular migraine (VM) is a subtype of migraine characterized by recurrent episodes of vertigo or dizziness, often accompanied by nausea, light and sound sensitivity, and other vestibular symptoms. It primarily affects females at a 5:1 ratio, with episodes lasting from minutes to 72 h, occurring with or without headaches. VM is one of the more frequent causes of recurrent vertigo, affecting around 1% to 2.7% of the population.

To analyze the clinical profile of patients with vestibular migraine (VM) treated in a tertiary care center in South India.

This retrospective observational study reviewed 45 patients diagnosed with VM between January 1, 2021, and June 30, 2023, based on the International Classification of Headache Disorders (ICHD) criteria. Demographic data, clinical characteristics, and duration of hospital stay were analyzed.

The study included 34 female participants (75.6%) and 11 male participants (24.4%), with an average age of 45.3 years. 82.2% of patients reported symptom onset with headache, while 17.7% reported vertigo as the first symptom. The majority experienced daily to weekly episodes of dizziness and headache. Auditory symptoms were reported by 88.8% of patients, with tinnitus being the most common (48.8%). According to pure tone audiometry, 32.5% of patients had sensorineural hearing loss. VM episodes were often associated with menstrual periods, with 61.7% experiencing migraine during menstruation. Psychiatric illness was the most common comorbidity (20%). Cervical vestibular evoked myogenic potential (cVEMP) testing revealed increased latency in 17.7% of the patients and asymmetry in 15.5%. Most patients (84.4%) required hospital admission, with an average stay of 4.5 days.

Vestibular migraine predominantly affects females and is frequently associated with auditory symptoms, menstrual cycles, and psychiatric comorbidities. Early recognition and multidisciplinary management are crucial for improving patient outcomes.