The evaluation of the clinical properties of vestibular migraine patients admitted to outpatient balance clinic of the Neurology Department of Dokuz Eylul University Hospital in the last year

Objective: Vestibular migraine is a disease, characterized by recurrent vertigo and migraine attacks and accompanied by various neurootological findings. The aim of this study is to describe the headache and vertigo characteristics of the vestibular migraine and to evaluate the motion sickness disease which is frequently diagnosed in migraine and the familial history of migraine in patients admitted to our outpatient balance clinic. Method: In our study, 102 patients who were diagnosed as definite and possible vestibular migraine (VM) according to the criteria of ICHD-3 in the last year at Dokuz Eylül University Hospital Neurology Department were evaluated retrospectively. Demographic information, familial history of migraine and vertigo, headache and vertigo features were examined. Results: The mean age of vestibular migraine patients was 42,69 ± 14,15 in the definitive vestibular migraine (DVM) group and 48,55 ± 14,57 in the possible vestibular migraine (PVM) group. Gender distribution is 14,7% male and 85,3% female. Headache (HA) onset time was 16.62 ± 12.86 years in the DVM group; 14,36 ± 11,43 years in PVM group. The mean duration of vertigo was 56,41 ± 81,83 months in the DVM group and 20,85 ± 30,19 months in the PVM group. In 73,0% patients HA was started before vertigo, in 5,4% patient vertigo was the initial symptom, in 21,6% paitents HA and vertigo started at the same time. 96,2% of the patients had a history of vertigo and HA together. It was seen that they were diagnosed at an average of second center with a maximum of tenth and a minimum of first. The duration of the vertigo episodes was 49,0% in seconds, 23,5% in minutes, 19,6% longer than 1 hour, 7,88% longer than 24 hours. Vertigo episodes were evaluated with 36,7% mild, 16,7% moderate and 46,7% severe intensity. There was no significant relationship between HA and vertigo intensity (p=0,491). Vertigo characteristics included spontaneous vertigo (59,8%), dizziness (53,9%), positional vertigo (38,2%), dizziness induced by head movements (37,3%) and less frequently vertigo induced by head movements, visually induced vertigo, swinging sensation, imbalance and walking sensation in space were determined. There was a significant difference in dizziness triggered by head movements between the DVM and PVM groups (p=0,011). Among the triggers of vertigo episodes, the most frequently reported were: being in a shopping mall or in a closed area, fatigue, stress, hunger and insomnia. Vertigo episodes were associated with a menstruation period (56%). The motion sickness susceptibility was found to be in high rates (84,0%). Severe intensity vertigo episodes was observed in 70% of patients with motion sickness susceptibility, but no statistically significant relationship was found (p=0,877). 71,4% of the patients had auditory symptoms and 21,4% had hearing loss. Allergic symptoms were seen in high rates (58,8%). 93,2% of the patients had a history of migraine in the family. It was determined that 39,2% of the patients had benign paroxismal positional vertigo and 20% of these patients had positional nystagmus. It was determined that the patients who received prophylactic treatment had a full and partial benefit of 82,7% in the intensity, frequency and duration of the episodes. Conclusion: Vertigo is one of the most common reasons for referral to the clinic in daily practice. Investigation of the history of migraine, the clinical features of vertigo, and other accompanying signs will eliminate the difficulties in diagnosing vestibular migraine and prevent patients from applying to more than one health institution. Determining the triggering factors by detailed history and avoiding them will significantly reduce the functional loss of patients.