Vestibular and oculomotor function in patients with vestibular migraine

Am J Otolaryngol. 2021 Nov-Dec;42(6):103152. doi: 10.1016/j.amjoto.2021.103152. Epub 2021 Jun 29.

Abstract

Aim: The purpose of this study was to assess the vestibular and oculomotor function in patients with vestibular migraine (VM). And we also investigate the relationship between testing results and effectiveness of preventive medications in VM.

Material and method: 41 patients with VM were recruited in this study and examined with cervical and ocular vestibular evoked myogenic potential(cVEMP, oVEMP), video head impulse test(vHIT), caloric test and videonystagmography. All patients were treated with preventive medications. We calculated symptomatic improvement and record episodes frequency in patients with VM. Six months later, the effectiveness of preventive medications were evaluated and the relationship between vestibular testing and effectiveness of preventive medications were analyzed further.

Results: In vestibular function testing, 73% of patients with VM showed abnormal results. Abnormal cVEMP, oVEMP, vHIT, and caloric test were found in 20%, 44%, 32% and 56% respectively. The abnormal rate of oVEMP was significantly higher than that of cVEMP(p < 0.05). And the proportion of abnormal caloric test was obviously higher than that of vHIT (p < 0.05). In oculomotor function testing, 42% of the patients with VM showed pathological results which was significantly lower than that of vestibular function testing(p < 0.05). After 6 months follow-up, the proportion of prophylactic medication effectiveness was significantly higher in normal vestibular function testing group compared with the abnormal group (p < 0.05).

Conclusion: Abnormal vestibular and oculomotor functions are commonly observed in patients with VM. And these patients with abnormal vestibular function possess a weak effectiveness of preventive medications.

Keywords: Oculomotor function; Preventive medications; Vestibular function; Vestibular migraine.

MeSH terms

  • Adult
  • Aged
  • Caloric Tests
  • Female
  • Follow-Up Studies
  • Head Impulse Test / methods
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / physiopathology*
  • Migraine Disorders / prevention & control
  • Oculomotor Nerve / physiopathology*
  • Time Factors
  • Treatment Outcome
  • Vestibular Evoked Myogenic Potentials
  • Vestibular Function Tests / methods*
  • Vestibule, Labyrinth / physiopathology*
  • Young Adult