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Abstract Details

Vestibular Migraine: Symptoms, Triggers, Exam Findings & Co-morbid Disorders
Headache
S20 - Headache Imaging and Physiology and Episodic Syndromes Associated with Migraine (4:58 PM-5:09 PM)
009

VM is the most common neurologic cause of vertigo that causes significant disability in adults, but remains an under-recognized and under-diagnosed disorder.
To investigate the ictal and interictal symptoms, psychiatric comorbidities, and interictal neuro-otologic examination findings in vestibular migraine (VM).
Retrospective review of patients seen between August 2014 until March 2018 at a tertiary neurology referral center for vestibular disorders to identify patients fulfilling the 2012 VM diagnostic criteria.
131 patients (105 women) were identified for this study. Mean age of VM onset was 44.3 (±13.7) years. A history of migraine preceding vestibular symptom onset was present in 57.3%. A family history of migraine was reported by 50.8%; 28.1% reported a family history of episodic vestibular symptoms. Common ictal symptoms were triggered vertigo (visually-induced and head-motion) and spontaneous vertigo, accompanied by photophobia and phonophobia (90.1%), nausea (80.2%), auditory symptoms (60.3%), and headache (49.6%). Interictally, many experienced visually-induced dizziness (88.6%), head-motion dizziness (65.6%), and persistent dizziness (51.1%); and motion sickness (61.1%). Psychiatric comorbidities include anxiety (70.2%), depression (40.5%), insomnia (29.0%), phobic disorders (11.5%), and psychogenic disorders (8.4%). Common triggers were stress (39.7%), bright lights (26.7%), weather changes (26.0%), and sleep deprivation (26.0%). Interictal neuro-otologic examination was abnormal in 41.9%; common findings include hyperventilation-induced, head-shaking-induced, vibration-induced, and positional nystagmus. The most common balance test abnormality was impaired sharpened Romberg’s test (16.9%).
VM typically affects women in their 40s, with a personal and family history of migraine. Typical ictal symptoms were triggered and spontaneous vertigo, associated with photophobia and phonophobia, nausea, auditory symptoms and headache. Interictal vestibular symptoms, and comorbid psychiatric disorders are common. Abnormal, albeit non-specific interictal neuro-otologic findings were frequent.
Authors/Disclosures
Shin C. Beh, MD, FAAN (Beh Center for Vestibular & Migraine Disorders)
PRESENTER 		Dr. Beh has received publishing royalties from a publication relating to health care.
Shamin Masrour, MD (UT Southwestern Medical Center) Dr. Masrour has nothing to disclose.
Stacy V. Smith, MD (Houston Methodist Neurosciences Center) Dr. Smith has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva. Dr. Smith has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for TEVA . Dr. Smith has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lilly. Dr. Smith has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Dr. Smith has received publishing royalties from a publication relating to health care.
Deborah I. Friedman, MD, MPH, FAAN Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Friedman has received personal compensation in the range of $0-$499 for serving as a Consultant for Satsuma. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Axsome. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Impel. Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology Reviews. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink Neurology . The institution of Dr. Friedman has received research support from Spinal CSF Leak Foundation. Dr. Friedman has a non-compensated relationship as a Program Co-Chair, Scottsdale Headache Symposium with American Headache Society that is relevant to AAN interests or activities. Dr. Friedman has a non-compensated relationship as a Medical Advisor with Spinal CSF Leak Foundation that is relevant to AAN interests or activities. Dr. Friedman has a non-compensated relationship as a Treasurer, Board of Directors with Southern Headache Society that is relevant to AAN interests or activities.