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 Volume 73, Number 8, August 25, 2009
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NEUROLOGY 2009;73:638-642
© 2009 American Academy of Neurology

Vertigo as a migraine trigger

Louisa Murdin, MD, Rosalyn A. Davies, MD, PhD and Adolfo M. Bronstein, MD, PhD

From the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.

Address correspondence and reprint requests to Professor A.M. Bronstein, Clinical Neuro-Otology Department, Imperial College School of Medicine, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK a.bronstein{at}imperial.ac.uk

Background: It is reported in some individual patients that vestibular stimuli can trigger migraine attacks. This study used a case-control design to examine systematically the hypothesis that vertigo induced by vestibular stimulation (rotation/caloric testing) can act as a specific migraine trigger.

Methods: A total of 123 new patients attending neuro-otology or neurology clinics were studied with questionnaires and physician interview to ascertain migraine history according to International Headache Society criteria. A total of 79 who underwent rotation/caloric vestibular testing (test group) were compared with 44 control patients in whom no such testing was carried out (control group). The principal outcome measure was the occurrence of a migraine attack within 24 hours of exposure to vestibular stimulation.

Results: Of those participants with a past history of migraines, 19/39 (49%) of the test group experienced a migraine in the study time window, compared with 1/21 (5%) of the control group. Binary logistic regression analysis confirmed that vestibular testing was associated (p < 0.05) with migraine attacks.

Conclusions: The results indicate that induced vertigo can act as a migraine trigger, a finding with implications for the diagnosis of patients with episodic vertigo and migraine headache. While such patients may well have basilar migraine or migrainous vertigo, alternatively, another disorder causing episodic vertigo (e.g., benign paroxysmal positional vertigo or Ménière disease) may be triggering migraine headaches.

Abbreviations: CI = confidence interval; IHS = International Headache Society.

Disclosure: Author disclosures are provided at the end of the article.

Received March 2, 2009. Accepted in final form May 26, 2009.






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