Presence and Clinical Value of Vestibular Symptoms in Migraine

Abstract Objective: To evaluate the correlations between the characteristics of vestibular symptoms and migraine, and to explore the clinical value of vestibular symptoms in patients with migraine.Methods: Consecutive patients who visited the outpatient Department of Neurology and presented with a principal complaint of headache were enrolled. Patients with primary headache diagnosed according to International Classification of Headache Disorders (ICHD-3) were divided into the episodic migraine group (EM), chronic migraine group (CM) and tension-type headache group (TTH). Information on clinical symptoms was collected with a semistructured questionnaire, and the characteristics of the vestibular symptoms were recorded.Results: 451 patients were recruited, with 235 EM, 187 CM and 29 TTH. The proportion of patients with vestibular symptoms in the migraine (108/422) was higher than that in the TTH (1/29), and the frequency of vestibular symptoms in the CM was higher. 2-8 days per month was the highest in the EM (131/235), and the migraine features and accompanying symptoms were the most typical. The highest proportion of patients with separate attacks of headache and vestibular symptoms was observed in the low-frequency headache (68.8%) (p<0.05). With an increase in headache frequency, the proportion of concurrent attacks of headache and vestibular symptoms gradually increased, a headache frequency of 8 days per month was a cut-off point for migraine.Conclusion: Vestibular symptoms occur frequently in patients with CM, and the presence of concurrent attacks of vestibular symptoms and headache was significantly related to the headache frequency. A headache frequency of 8 days per month is recommended as a warning sign for CM. Patients with headaches 2-8 days per month have the most typical characteristics and should be selected for clinical trial.