Clinical Features of Midlife Women With Isolated Episodic Vestibular Syndrome and Their Relationship With Migraine...

To describe the clinical features of middle-aged women with isolated spontaneous episodic vestibular syndrome, focusing on vestibular, audiological, migraine-related, and climacteric symptoms.

This cross-sectional study included women aged 40 to 65 years with recurrent spontaneous vestibular symptoms and no hearing loss, evaluated at a tertiary neurotology outpatient clinic. Participants underwent a semi-structured clinical interview and completed the Dizziness Handicap Inventory (DHI), Menopause Rating Scale (MRS), and Migraine Disability Assessment (MIDAS). Clinical features were described, and associations between DHI scores, clinical features, MRS, and MIDAS were examined.

Ninety-three patients were included. Most experienced episodes at least weekly (80.6%), typically lasting seconds to minutes (74.2%) and frequently triggered by head motion (88.2%). Episodes were commonly associated with headaches (54.8%) and emotional distress (63.4%). Frequent accompanying symptoms included tinnitus (78.5%), hyperacusis (62.4%), motion sickness (59.1%), photophobia (59.1%), neck pain (60.2%), and vasomotor symptoms (59.1%). DHI scores were significantly higher in patients with tinnitus (P=0.042). Although 19.2% did not meet diagnostic criteria for vestibular migraine (VM), 95.7% reported at least one migraine-related symptom. DHI scores correlated significantly with MRS (P=0.0007) but not with MIDAS (P=0.819).

Middle-aged women with isolated episodic vestibular syndrome show a consistent pattern of brief, recurrent symptoms often accompanied by auditory, emotional, migraine-related, and vasomotor features. Tinnitus is associated with greater disability, and menopausal symptoms significantly correlate with dizziness-related handicap.