The interrelations of migraine, vertigo, and migrainous ...

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The interrelations of migraine, vertigo, and migrainous vertigo

H. Neuhauser, MD; M. Leopold; M. von Brevern, MD; G. Arnold, MD; and T. Lempert, MD

"Objective: To assess the prevalence of migrainous vertigo in patients with migraine and in patients with vertigo according to explicit diagnostic criteria that are presented for discussion. Methods: The authors prospectively evaluated 200 consecutive patients from a dizziness clinic and 200 patients from a migraine clinic for migrainous vertigo based on the following criteria: 1) recurrent vestibular symptoms (rotatory/positional vertigo, other illusory self or object motion, head motion intolerance); 2) migraine according to the criteria of the International Headache Society (IHS); 3) at least one of the following migrainous symptoms during at least two vertiginous attacks: migrainous headache, photophobia, phonophobia, visual or other auras; and 4) other causes ruled out by appropriate investigations. In addition, the authors compared the prevalence of migraine according to the IHS criteria in the dizziness clinic group with a sex- and age-matched control group of 200 orthopedic patients. Results: The prevalence of migraine according to the IHS criteria was higher in the dizziness clinic group (38%) compared with the age- and sex-matched control group (24%, p , 0.01). The prevalence of migrainous vertigo was 7% in the dizziness clinic group, and 9% in the migraine clinic group. In 15 of 33 patients with migrainous vertigo, vertigo was regularly associated with migrainous headache. In 16 patients, vertigo occurred both with and without headache, and in two patients headache and vertigo never occurred together. The duration of attacks varied from minutes to days. Conclusion: These results substantiate the epidemiologic association between migraine and vertigo"

http://www.mvertigo.org/articles/Interr ... ertigo.pdf

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Women who suffer migraine with aura in middle age face increased risk for infarct-like brain lesions on MRI later in life, according to a population-based cohort study in JAMA.
Nearly 4700 adults in Iceland were interviewed about headache symptoms in midlife (mean age, 51) and then underwent brain MRI some 25 years later. In adjusted analyses, adults who reported migraine with aura at least once a month in midlife were at increased risk for infarct-like lesions later on. The increased risk was due to an excess of cerebellar infarcts among women who had migraine with aura (23%, vs. 14% among women without at least monthly headache).
Migraine without aura and nonmigraine headache were not associated with infarct risk.
Editorialists advise caution when interpreting these results, writing: "In the absence of the source and the nature of infarct-like lesions and the absence of clinical symptoms or consequences, it is premature to conclude that migraine has hazardous effects on the brain."

JAMA article (Free abstract; full text requires subscription)
JAMA editorial (Subscription required)
Physician's First Watch coverage of study showing link between migraine with aura and CVD in women (Free)
Physician's First Watch [FirstWatch@jwatch.org]