Document Detail

Vestibular migraine: Long-term follow-up of clinical symptoms and vestibulo-cochlear findings.
MedLine Citation:
PMID:  23019266     Owner:  NLM     Status:  Publisher    
OBJECTIVE: The aim of the study was to assess the evolution of clinical symptoms and vestibulo-cochlear function in patients with definite vestibular migraine (dVM). METHODS: We reassessed 61 patients (54 women, 7 men, aged 24-76 years) with dVM according to validated diagnostic criteria after a median follow-up time of 9 years (range, 5.5-11). Assessment comprised a clinical interview and neurotologic examination, including pure-tone audiometry and caloric testing. RESULTS: The majority of patients (87%) had recurrent vertigo at follow-up. Frequency of vertigo was reduced in 56%, increased in 29%, and unchanged in 16%. Impact of vertigo was severe in 21%, moderate in 43%, and mild in 36%. Eighteen percent reported mild persistent unsteadiness. Interictal ocular motor abnormalities had increased from 16% initially to 41% of patients at follow-up. The most frequent finding was positional nystagmus (PN), in 28%, including definite central-type PN in 18%. However, only 1 of 9 patients with ocular motor abnormalities at initial presentation showed similar findings on follow-up. Concomitant cochlear symptoms with vertigo had increased from 15% initially to 49%. Eleven patients (18%) had developed mild bilateral sensorineural hearing loss, which also involved the low-frequency range. CONCLUSIONS: The majority of patients continue to have recurrent vertigo in the long-term evolution of VM, and the impact of vertigo may remain severe. Whereas interictal ocular motor abnormalities may show some variation over time, vestibulo-cochlear dysfunction progresses slowly in some patients with VM. Interictal central-type PN may help distinguish VM from peripheral vestibular disorders such as Ménière disease.
Andrea Radtke; Michael von Brevern; Hannelore Neuhauser; Tilman Hottenrott; Thomas Lempert
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-26
Journal Detail:
Title:  Neurology     Volume:  -     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
From the Department of Neurology, Charité (A.R.); Parkklinik Weissensee (M.v.B.); Robert Koch Institute (H.N.); Department of Neurology, University Freiburg (T.H.); and Schlosspark-Klinik (T.L.), Berlin, Germany.
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