Res Vestib Sci.
2012 Mar;11(1):1-7.
Clinical Manifestations and Neuro-otological Findings of Migrainous Vertigo
- Affiliations
-
- 1Department of Neurology, Chonnam National University Medical School, Gwangju, Korea. nrshlee@chonnam.ac.kr
- 2Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
- 3Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.
Abstract
- BACKGROUND AND OBJECTIVES
Migrainous vertigo (MV) is one of the recurrent vestibular syndromes and may present episodic vestibular and concurrent migraine symptoms. The clinical manifestations and neuro-otological findings of MV have been delineated over the last couple of decades, however, there are still lots of uncertainties.
MATERIALS AND METHODS
We performed a comprehensive literature search regarding the clinical manifestations and neuro-otological findings of MV compatible with the diagnostic criteria proposed by Neuhuaser. We found the published articles that addressed the clinical and neuro-otological findings and we performed a pooled analysis.
RESULTS
Even though the duration of MV attack was variable from seconds to days, the most common durations investigated in this study was minutes (range, 5-60 minutes). During MV attack, most patients had a migraine headache, but instead the other migraine symptoms (i.e., photophobia, phonophobia) could be found. There were positional nystagmus which may not meet a stimulated canal plane and spontaneous nystagmus and, less commonly, gaze-evoked nystagmus. Regarding bithermal caloric test, unilateral canal paresis could be found in 15-20% of MV patients as well as hyperexcitability in some patients. Oculomotor tests might show impaired pursuits (mainly saccadic pursuit) and saccadic abnormalities such as delayed latency and hypometric saccade.
CONCLUSION
From the result of the pooled analysis, we have found several clinical and neuro-otological findings. However, vital neuro-otological findings which can provide a clue for the diagnosis of MV are still lacking. So the diagnosis of MV should depend on the clinical manifestations and a process of differential diagnosis.
