Comparison of clinical features between vestibular migraine and migraine without vertigo

Aim: Vestibular migraine and migraine without vertigo are clinically similar and differentiated in many points. The aim of this study was to evaluate the headache characteristics of both groups, the loss of function caused by headache, to investigate the presence and degree of anxiety and depression, the effect of existing diseases on the quality of life and to compare these findings between the two groups. It is also aimed to assess the vertigo characteristics, neurootological findings and loss of function caused by vertigo in vestibular migraine group. Material and Method: In our study, 35 patients with vestibular migraine diagnosis(according to ICHD beta version 3) and 35 patients with migraine without vertigo (aura +/-) were included in DEÜTF Neurology Department Policlinic. The Migraine Disability Assessment (MIDAS), 12-item Allodynia Symptom Checklist (ASC-12), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), health anxiety inventory (HAI), World Health Organization Quality Of Life Questionaire Short Form -12(WHOQL-SF12), The Activities Specific Balance Confıdence (ABC) Scale were compared in both groups. Dizziness Handicap Inventory was assessed in the vestibular migraine group. The headache characteristics of both groups were evaluated with anamnesis form. Results: The onset age of headache in the VM group was 26.2 (± 11.16); 20.91 (± 5.93) in the MWV group and later in the VM group (p = 0.038). Vestibular symptoms in the VM group; Twenty-one (60%) patients were describe sense of environmental rotation. Vertigo and headache were in the same attack in 17(%48,6) patient. In the VM patient group, the number of migraine patients who diagnosed with migraine at the time of admission with vertigo was 22 (66.7% and 19 (76%) of these patients had migraine history in their family. MIDAS grade average; 2.59 (± 1.32) in the VM group, 2.82 (± 1.16) in the VM group and there was no significant difference (p = 0,352). BDI; 11.29 (± 8,30) in the VM group, 7.21 (± 6.64) in the MWV group and significantly higher in the VM group (p = 0.024). The STAI mean was 38.88 (± 4.95) in the VM group, 41.68 (± 6.67) in the MWV group and significantly higher in the MWV group (p = 0.042). There was no significant difference in the mean values of HAI, VM group's mean was (14,14 ± 5,93) and in the MWV group's mean was (13,51 ± 5,38) (p = 0,173). DHI were assessed in the VM group with a mean of 50 (± 21.44) and showed moderate disability. The mean ABC Scale was 62.97% (± 20.79) in the VM group and 84.84% (20.33) in the MWV group and significantly higher in the VM group (p = 0). The ASC averages; 4.54 (± 3.44) in the VM group, 5.57 (± 5.44) in the MWV group and there was no significant difference. WHOQL-SF12 mean was 51.04% (± 22.74) in the VM group and 61.04% (± 20.02) in the MWV group and there was no significant difference (p = 0.06). In the VM group, benign paroxysmal positional vertigo (BPPV) was present in 18 patients and all of the patients benefited from the Epley maneuver. Conclusion: Anxiety and depression are comorbid problems in VM and BDOM. Both diseases cause disability and have negative affect on life quality. The vestibular findings of VM patients vary, the disease affects the balance in daily activities negatively, and vertigo and headache increase the loss of function in these patients. It should kept in mind in clinical practise, migraine may be the reason of vertigo and treating migraine attacks also reduces vertigo. Therefore headache should be questioned. In addition, in the presence of BPPV in vestibular migraine patients, corrective maneuvers provide additional benefit. Key Words: Vestibular migraine, Migraine, Anxiety, Depression, Quality of Life