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Migrainous vertigo

Prevalence and impact on quality of life

From the Department of Epidemiology (H.K.N., T.Z.), Robert Koch Institute; Vestibular Research Group (H.K.N., A.R., M.v.B., M.F., F.L., T.L.), Department of Neurology, Charité; and Department of Neurology (T.L.), Schlosspark-Klinik, Berlin, Germany.

Address correspondence and reprint requests to Dr. H. Neuhauser, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany; e-mail: neuhauserh{at}rki.de

Objective: To investigate the epidemiology of migrainous vertigo (MV) in the general population by assessing prevalence, clinical features, comorbid conditions, quality of life, and health care utilization.

Methods: We screened a representative sample of the adult population in Germany (n = 4,869) for moderate or severe dizziness/vertigo and followed up with validated neurotologic telephone interviews (n = 1,003). Diagnostic criteria for MV were as follows: 1) recurrent vestibular vertigo; 2) migraine according to the International Headache Society; 3) migrainous symptoms during at least two vertiginous attacks (migrainous headache, photophobia, phonophobia, or aura symptoms); and 4) vertigo not attributed to another disorder. In a concurrent validation study (n = 61) the interviews had a sensitivity of 84% and a specificity of 94% for vestibular vertigo and 81% and 100% for migraine.

Results: The lifetime prevalence of MV was 0.98% (95% CI 0.70 to 1.37), the 12-month prevalence 0.89% (95% CI 0.62 to 1.27). Spontaneous rotational vertigo was reported by 67% of participants with MV while 24% had positional vertigo. Twenty-four percent always experienced headaches with their vertigo. Logistic regression analysis comparing participants with MV with dizziness-free migraineurs showed an independent association with coronary heart disease but not with sex, age, migrainous aura, education, stroke, hypertension, hyperlipidemia, body mass index, or depression. Age-adjusted health-related quality of life scores (SF-8 Health Survey) were consistently lower in participants with MV compared to dizziness-free controls. Two thirds of participants with MV had consulted a doctor but only 20% of these were diagnosed with MV.

Conclusions: Migrainous vertigo is relatively common but underdiagnosed in the general population and has considerable personal and healthcare impact.

Disclosure: The authors report no conflicts of interest.

Received December 23, 2005. Accepted in final form May 12, 2006.

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