Background: Vestibular dysfunction has been long described in patients with migraine. There is paucity in the studies investigating the function of otolith organ and vestibulospinal tract serving linear acceleration and balance functions in migraineurs. Objective: To asses the frequency of symptoms of vestibular dysfunction and the vestibulo-spinal reflex in patients with migraine, in headache free periods, using computerized dynamic posturography (CDP) and vestibular evoked myogenic potentials (VEMPs). Methods: A case control study including 24 patients with migraine and 20 normal volunteers. Patients have undergone history taking emphasizing on vestibular and balance problems and neuro-otological assessment. All subjects have undergone computerized dynamic posturography and VEMPs. Results: Vertigo/Dizziness complaints were reported by 54% of patients; 3 of them had benign paroxysmal positional vertigo. Vestibular symptoms did not differ between migraineurs with and without aura. Abnormal posturographic findings were present in 37.5% of patients mostly in conditions 5 and 6. Abnormal VEMPs were present in 75% of patients mostly in the form of delayed latencies of P13 and N23. The mean latencies of P13 and N23 were significantly higher in patients than controls, but with no difference in amplitude of P13-N23. No significant difference was present in patients with or without aura, vertigo/dizziness, or symptoms of brainstem dysfunction regarding any of CDP or VEMP parameters. Conclusion: Vertigo and dizziness are frequent co-existing symptoms in patients with migraine. VEMPs and CDP abnormalities are significantly more frequent in migraineurs than in healthy controls denoting vestibulo-spinal dysfunction in migraineurs. (Egypt J Neurol Psychiat Neurosurg. 2010; 47(1): 67-74).
Key Words: Migraine, vestibular dysfunction, computerized dynamic posturography, vestibular evoked myogenic potentials
Correspondence to Nevin M. Shalaby, Department of neurology, Cairo University, Egypt.
Tel: +2 0101493242 E-mail: nevinmohy@yahoo.com