Roberto Teggi1, Bruno Colombo2, Roberto Albera3, Giacinto Asprella Libonati4, Cristiano Balzanelli5, Angel Batuecas Caletrio6, Augusto Casani7, Juan Manuel Espinoza-Sanchez8,9, Paolo Gamba10, Jose A Lopez-Escamez11,12, Sergio Lucisano3, Marco Mandalà13, Giampiero Neri14, Daniele Nuti13, Rudy Pecci15, Antonio Russo16, Eduardo Martin-Sanz17, Ricardo Sanz17, Gioacchino Tedeschi16, Paola Torelli18, Paolo Vannucchi15, Giancarlo Comi2, Mario Bussi1. 1. ENT Department, San Raffaele Scientific Hospital, Milan, Italy. 2. Headache Unit, Department of Neurology, San Raffaele Scientific Hospital, Milan, Italy. 3. Dipartimento di Scienze, Chirurgiche Università di Torino, Turin, Italy. 4. U.O.S.D. "Vestibologia e Otorinolaringoiatria" Presidio Ospedaliero "Giovanni Paolo II,", Policoro, MT, Italy. 5. Department of Otolaryngology, Spedali Civili, University of Brescia, Brescia, Italy. 6. Otoneurology Unit, Department of Otorhinolaryngology, University Hospital of Salamanca, IBSAL, Salamanca, Spain; Skull Base Unit, Department of Otorhinolaryngology, University Hospital of Salamanca, IBSAL, Salamanca, Spain. 7. Department of Otorhinolaryngology-Pisa University Medical School Otorhinolaryngology, Pisa University Medical School, Pisa, Italy. 8. Otology and Neurotology Group, Department of Genomic Medicine, Centre for Genomics and Oncological Research (GENYO), Pfizer-University of Granada-Junta de Andalucia, Granada, Spain. 9. Department of Otolaryngology, Hospital San Agustin, Linares, Jaen, Spain. 10. Department of Otorhinolaryngology-Head and Neck Surgery, Poliambulanza Foundation Hospital, Brescia, Italy. 11. Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO-Centre for Genomics and Oncological Research, Pfizer/University of Granada/Junta de Andalucia, PTS, Granada, Spain. 12. Division of Otoneurology, Department of Otolaryngology, Hospital Universitario Virgen de las Nieves, Granada, Spain. 13. Otology and Skull Base Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy. 14. Department of Neurosciences, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti, Italy. 15. Unit of Audiology, Department of Surgical Sciences and Translational Medicine, Careggi Hospital, University of Florence, Florence, Italy. 16. University of Campania Luigi Vanvitelli, Naples, Italy. 17. Department of Otolaryngology, University Hospital of Getafe, Madrid, Spain. 18. Department of Neurosciences, Headache Centre, University of Parma, Parma, Italy.
Abstract
OBJECTIVE: The aim of this work was to assess through a questionnaire the features of vertiginous episodes, accompanying symptoms, familial history, and migraine precursors in a sample of 252 subjects with a diagnosis of definite vestibular migraine. BACKGROUND: Migraine is a common neurological disorder characterized by episodic headaches with specific features. About two-thirds of cases run in families, and patients may refer symptoms occurring in infancy and childhood, defined as episodic syndromes that may be associated with migraine. Migraine is associated with episodic vertigo, called vestibular migraine, whose diagnosis mainly relies on clinical history showing a temporary association of symptoms. METHODS: In this cross-sectional multicentric study, 252 subjects were recruited in different centers; a senior specialist through a structured questionnaire assessed features of vestibular symptoms and accompanying symptoms. RESULTS: The age of onset of migraine was 23 years, while onset of vertigo was at 38 years. One hundred and eighty-four subjects reported internal vertigo (73%), while 63 subjects (25%) reported external vertigo. The duration of vertigo attacks was less than 5 minutes in 58 subjects (23%), between 6 and 60 minutes in 55 (21.8%), between 1 and 4 hours in 29 (11.5%), 5 and 24 hours in 44 (17.5%), up to 3 days in 14 (5.5%), and more than 3 days in seven (2.8%); 14 subjects (5.5%) referred attacks lasting from less than 5 minutes and up to 1 hour, nine (3.6%) referred attacks lasting from less than 5 minutes and up to 1 to 4 hours, six (2.4%) referred attacks lasting from less than 5 minutes and up to 5 to 24 hours, and five (2%) cases referred attacks lasting from less than 5 minutes and up to days. Among accompanying symptoms, patients referred the following usually occurring, in order of frequency: nausea (59.9%), photophobia (44.4%), phonophobia (38.9%), vomiting (17.8%), palpitations (11.5%), tinnitus (10.7%), fullness of the ear (8.7%), and hearing loss (4%). In total, 177 subjects referred a positive family history of migraine (70.2%), while 167 (66.3%) reported a positive family history of vertigo. In the sample, 69% of patients referred at least one of the pediatric precursors, in particular, 42.8% of subjects referred motion sickness. The age of onset of the first headache was lower in the subsample with a familial history of migraine than in the total sample. Among the pediatric precursors, benign paroxysmal vertigo - BPV, benign paroxysmal torticollis, and motion sickness were predictive of a lower age of onset of vertigo in adulthood; cyclic vomiting was predictive for vomiting during vertigo attacks in adults. CONCLUSIONS: Our results may indicate that vestibular symptoms in pediatric patients may act as a predisposing factor to develop vestibular migraine at an earlier age in adulthood.
OBJECTIVE: The aim of this work was to assess through a questionnaire the features of vertiginous episodes, accompanying symptoms, familial history, and migraine precursors in a sample of 252 subjects with a diagnosis of definite vestibular migraine. BACKGROUND:Migraine is a common neurological disorder characterized by episodic headaches with specific features. About two-thirds of cases run in families, and patients may refer symptoms occurring in infancy and childhood, defined as episodic syndromes that may be associated with migraine. Migraine is associated with episodic vertigo, called vestibular migraine, whose diagnosis mainly relies on clinical history showing a temporary association of symptoms. METHODS: In this cross-sectional multicentric study, 252 subjects were recruited in different centers; a senior specialist through a structured questionnaire assessed features of vestibular symptoms and accompanying symptoms. RESULTS: The age of onset of migraine was 23 years, while onset of vertigo was at 38 years. One hundred and eighty-four subjects reported internal vertigo (73%), while 63 subjects (25%) reported external vertigo. The duration of vertigo attacks was less than 5 minutes in 58 subjects (23%), between 6 and 60 minutes in 55 (21.8%), between 1 and 4 hours in 29 (11.5%), 5 and 24 hours in 44 (17.5%), up to 3 days in 14 (5.5%), and more than 3 days in seven (2.8%); 14 subjects (5.5%) referred attacks lasting from less than 5 minutes and up to 1 hour, nine (3.6%) referred attacks lasting from less than 5 minutes and up to 1 to 4 hours, six (2.4%) referred attacks lasting from less than 5 minutes and up to 5 to 24 hours, and five (2%) cases referred attacks lasting from less than 5 minutes and up to days. Among accompanying symptoms, patients referred the following usually occurring, in order of frequency: nausea (59.9%), photophobia (44.4%), phonophobia (38.9%), vomiting (17.8%), palpitations (11.5%), tinnitus (10.7%), fullness of the ear (8.7%), and hearing loss (4%). In total, 177 subjects referred a positive family history of migraine (70.2%), while 167 (66.3%) reported a positive family history of vertigo. In the sample, 69% of patients referred at least one of the pediatric precursors, in particular, 42.8% of subjects referred motion sickness. The age of onset of the first headache was lower in the subsample with a familial history of migraine than in the total sample. Among the pediatric precursors, benign paroxysmal vertigo - BPV, benign paroxysmal torticollis, and motion sickness were predictive of a lower age of onset of vertigo in adulthood; cyclic vomiting was predictive for vomiting during vertigo attacks in adults. CONCLUSIONS: Our results may indicate that vestibular symptoms in pediatric patients may act as a predisposing factor to develop vestibular migraine at an earlier age in adulthood.
Authors: Roberto Teggi; Bruno Colombo; Roberto Albera; Giacinto Asprella Libonati; Cristiano Balzanelli; Angel Batuecas Caletrio; Augusto P Casani; Juan Manuel Espinosa-Sanchez; Paolo Gamba; Jose A Lopez-Escamez; Sergio Lucisano; Marco Mandalà; Giampiero Neri; Daniele Nuti; Rudi Pecci; Antonio Russo; Eduardo Martin-Sanz; Ricardo Sanz; Gioacchino Tedeschi; Paola Torelli; Paolo Vannucchi; Giancarlo Comi; Mario Bussi Journal: Front Neurol Date: 2018-06-05 Impact factor: 4.003
Authors: Thomas Lempert; Jes Olesen; Joseph Furman; John Waterston; Barry Seemungal; John Carey; Alexander Bisdorff; Maurizio Versino; Stefan Evers; Amir Kheradmand; David Newman-Toker Journal: J Vestib Res Date: 2022 Impact factor: 2.354
Authors: Roberto Teggi; Bruno Colombo; Roberto Albera; Giacinto Asprella Libonati; Cristiano Balzanelli; Angel Batuecas Caletrio; Augusto P Casani; Juan Manuel Espinosa-Sanchez; Paolo Gamba; Jose A Lopez-Escamez; Sergio Lucisano; Marco Mandalà; Giampiero Neri; Daniele Nuti; Rudi Pecci; Antonio Russo; Eduardo Martin-Sanz; Ricardo Sanz; Gioacchino Tedeschi; Paola Torelli; Paolo Vannucchi; Giancarlo Comi; Mario Bussi Journal: Front Neurol Date: 2020-01-24 Impact factor: 4.003
Authors: Julia Dlugaiczyk; Thomas Lempert; Jose Antonio Lopez-Escamez; Roberto Teggi; Michael von Brevern; Alexandre Bisdorff Journal: Front Neurol Date: 2021-06-17 Impact factor: 4.003