Vestibular migraine: comparative analysis between diagnostic criteria

Salmito, Márcio Cavalcante; Morganti, Lígia Oliveira Gonçalves; Nakao, Bruno Higa; Simões, Juliana Caminha; Duarte, Juliana Antoniolli; Ganança, Fernando Freitas

doi:10.1016/j.bjorl.2015.07.007

Acessibilidade / Reportar erro

Brasil

Brazilian Journal of Otorhinolaryngology

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLES • Braz. j. otorhinolaryngol. 81 (5) • Sep-Oct 2015 • https://doi.org/10.1016/j.bjorl.2015.07.007 copy

Vestibular migraine: comparative analysis between diagnostic criteria^☆ ☆ Please cite this article as: Salmito MC, Morganti LOG, Nakao BH, Simões JC, Duarte JA, Ganança FF. Vestibular migraine: comparative analysis between diagnostic criteria. Braz J Otorhinolaryngol. 2015;81:485-90.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

INTRODUCTION:

There is a strong association between vertigo and migraine. Vestibular migraine (VM) was described in 1999, and diagnostic criteria were proposed in 2001 and revised in 2012.

OBJECTIVE:

To compare the diagnostic criteria for VM proposed in 2001 with 2012 criteria with respect to their diagnostic power and therapeutic effect of VM prophylaxis.

METHODS:

Clinical chart review of patients attended to in a VM clinic.

RESULTS:

The 2012 criteria made the diagnosis more specific, restricting the diagnosis of VM to a smaller number of patients, such that 87.7% of patients met 2001 criteria and 77.8% met 2012 criteria. Prophylaxis for VM was effective both for patients diagnosed by either set of criteria and for those who did not meet any of the criteria.

CONCLUSIONS:

The 2012 diagnostic criteria for VM limited the diagnosis of the disease to a smaller number of patients, mainly because of the type, intensity, and duration of dizziness. Patients diagnosed with migraine and associated dizziness demonstrated improvement after prophylactic treatment of VM, even when they did not meet diagnostic criteria.

Keywords:
Migraine disorders; Vertigo; Dizziness; Diagnostic techniques and procedures

1. Neuhauser, 2001	2. Bárány Society and ICHD-3, 2012
Vestibular migraine, defined	Vestibular migraine
A. Vestibular symptoms at least of moderate intensity	A. At least five episodes with vestibular symptoms of moderate or severe intensity, lasting from 5 min to 72 h
B. Current or past history of migraine, according to International Headache Society criteria	B. Current or past history of migraine with or without aura, according to International Headache Society criteria
C. One of the following migraine symptoms during at least two attacks of vertigo: migraine, photophobia, phonophobia, visual or other auras	C. One or more of migraine symptoms in at least 50% of vestibular episodes: - headache with at least two of the following features: unilateral location, pulsating quality, intensity of pain (moderate to severe), worsened by physical activity - photophobia and phonophobia - visual aura
D. Other causes ruled out by an appropriate research	D. Cannot be better accounted for by another vestibular disease or a diagnosis of the ICHD-3
Comment: Vestibular symptoms include spinning dizziness or another movement or position illusion. They may be spontaneous or positional. Vestibular symptoms are “moderate” if they interfere, but do not prevent, daily activities, and “marked” if the patient is unable to carry out his/her daily activities

Probable vestibular migraine	Probable vestibular migraine
A. Vestibular symptoms of at least moderate intensity	A. At least five episodes with vestibular symptoms of moderate or severe intensity lasting from 5 min to 72 h
B. One of the following: (a) Current or past history of migraine according to 2004 criteria of the International Headache Society; (b) migraine symptoms during vestibular symptoms; (c) migraine precipitants of vertigo in more than 50% of attacks: food triggers, sleep problems, hormonal changes; and (d) response to anti-migraine drugs in more than 50% of attacks	B. Only one of the criteria B and C for vestibular migraine is fulfilled (history of migraine or migraine symptoms during the episode)
C. Other causes ruled out by appropriate research	C. Cannot be better accounted for by another vestibular disease or a diagnosis of the ICHD-3

Groups	Classification
A	All patients
B	VM by 2001 criteria
C	VM by 2012 criteria
D	Did not meet 2001 criteria
E	Did not meet 2012 criteria

Criteria	2001		2012		p-value
	n	%	n	%
Present	71	87.7%	63	77.8%	0.096
Absent	10	12.3%	18	22.2%
p-value	<0.001	<0.001

Group	Amitriptyline	Nortriptyline	Fluoxetine	Venlafaxine	Topiramate	Valproate	Flunarizine	Propranolol
A	22 (27.2%)	2 (2.5%)	3 (3.7%)	4 (4.9%)	18 (22.2%)	7 (8.6%)	13 (16.0%)	12 (14.8%)
B	19 (26.7%)	1 (1.4%)	2 (2.8%)	3 (4.2%)	17 (23.9%)	6 (8.5%)	13 (18.3%)	10 (14.1%)
C	17 (26.9%)	1 (1.6%)	2 (3.2%)	2 (3.2%)	13 (20.6%)	5 (7.9%)	13 (20.6%)	10 (15.8%)
D	4 (40%)	1 (10%)	1 (10%)	1 (10%)	1 (10%)	0	0	2 (20%)
E	7 (38.9%)	1 (5.6%)	1 (5.6%)	2 (11.1%)	4 (22.2%)	1 (5.6%)	0	2 (11.1%)

VAS for headache	Mean	SD	CI	p-value
Group A
Pre	7.70	1.97	0.50	<0.001
Post	3.33	2.61	0.66	<0.001

Group B
Pre	7.78	1.85	0.49	<0.001
Post	3.26	2.48	0.66	<0.001

Group C
Pre	7.80	1.94	0.54	<0.001
Post	3.41	2.55	0.71	<0.001

Group D
Pre	7.00	2.97	2.37	0.111
Post	4.00	3.85	3.08	0.111

Group E
Pre	7.27	2.15	1.27	0.001
Post	3.00	3.00	1.77	0.001

VAS for dizziness	Mean	SD	CI	p-value
Group A
Pre	6.74	2.29	0.57	<0.001
Post	2.79	2.54	0.63	<0.001

Group B
Pre	7.09	1.87	0.49	<0.001
Post	2.96	2.60	0.68	<0.001

Group C
Pre	7.02	1.74	0.48	<0.001
Post	3.02	2.65	0.73	<0.001

Group D
Pre	3.50	3.39	2.71	0.116
Post	1.17	0.98	0.79	0.116

Group E
Pre	5.58	3.70	2.10	0.005
Post	1.83	1.85	1.05	0.005

VAS	Mean	SD	CI	p-value
Headache
Group A	-4.37	3.00	0.76	0.846
Group B	-4.52	2.91	0.77
Group C	-4.39	3.00	0.84
Group D	-3.00	3.79	3.04
Group E	-4.27	3.17	1.87

Dizziness
Group A	-3.95	3.27	0.81	0.794
Group B	-4.13	3.28	0.86
Group C	-4.00	3.19	0.88
Group D	-2.33	3.01	2.41
Group E	-3.75	3.74	2.12

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] * Corresponding author. E-mail:marciosalmito@yahoo.com (M.C. Salmito).

Brasil

Brasil

Vestibular migraine: comparative analysis between diagnostic criteria☆ ☆ Please cite this article as: Salmito MC, Morganti LOG, Nakao BH, Simões JC, Duarte JA, Ganança FF. Vestibular migraine: comparative analysis between diagnostic criteria. Braz J Otorhinolaryngol. 2015;81:485-90.

ABSTRACT

INTRODUCTION:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSIONS:

Vestibular migraine: comparative analysis between diagnostic criteria^☆ ☆ Please cite this article as: Salmito MC, Morganti LOG, Nakao BH, Simões JC, Duarte JA, Ganança FF. Vestibular migraine: comparative analysis between diagnostic criteria. Braz J Otorhinolaryngol. 2015;81:485-90.