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Subclinical vestibulocerebellar dysfunction in migraine with and without aura

From the Departments of Neurology (Drs. Harno, Kallela, and Färkkilä) and Otolaryngology (Drs. Hirvonen, Aalto, Levo, and Isotalo), Helsinki University Central Hospital; and Department of Clinical Chemistry (M.A. Kaunisto, and Drs. Palotie and Wessman), Department of Public Health (Dr. Kaprio), and Finnish Genome Center (Dr. Palotie), University of Helsinki, Finland.

Address correspondence and reprint requests to Dr. Hanna Harno, Department of Neurology, Helsinki University Central Hospital, HUCH Institute, Haartmaninkatu 4 (P.O. BOX 105), 00029 HUS, Helsinki, Finland; e-mail: hanna.harno{at}hus.fi

Objective: In patients with migraine, neurotologic symptoms and signs occur commonly. The authors’ aim was to determine whether neurotologic findings are in accordance with the type of migraine and whether test findings differ from those of healthy controls.

Methods: The authors examined 36 patients with various types of migraine classified by International Headache Society criteria. Comprehensive neurotologic tests were performed between attacks: video-oculography (VOG), electronystagmography, static posturography, and audiometry on 12 patients with migraine with aura (MA) and 24 patients with migraine without aura (MO). Results were compared to those of test-specific nonmigrainous control groups. Only eight migraineurs (six with MA and two with MO) had vertigo or dizziness.

Results: Despite the absence of clinical neurotologic symptoms, most of the patients with migraine (83%) showed abnormalities in at least one of these tests. Both migraine types differed significantly from the control group (in VOG, in saccadic accuracy, and in static posturography). Vestibular findings tended to be more severe in MA than in MO.

Conclusions: These data suggest that interictal neurotologic dysfunction in MA and MO share similar features and that the defective oculomotor function is mostly of vestibulocerebellar origin.

Received March 13, 2003. Accepted in final form August 27, 2003.

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