Anamnestic factors and functional aspects in the selection of patients with migrainous vertigo

• Published in: European archives of oto-rhino-laryngology 2010-07, Vol.267 (7), p.1157-1162
• Main Authors: Faralli, Mario, Longari, Fabrizio, Crognoletti, Marianna, Ricci, Giampietro, Della Casa, Marco, Frenguelli, Antonio
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Female; Head and Neck Surgery; Humans; Male; Medical sciences; Medicine; Medicine & Public Health; Migraine Disorders - complications; Migraine Disorders - diagnosis; Migraine Disorders - physiopathology; Migraine Disorders - prevention & control; Miscellaneous; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Neurosurgery; Non tumoral diseases; Otorhinolaryngology; Otorhinolaryngology. Stomatology; Posture; Prospective Studies; Recurrence; Risk Factors; Surveys and Questionnaires; Vascular diseases and vascular malformations of the nervous system; Vertigo - diagnosis; Vertigo - etiology; Vertigo - physiopathology; Vertigo - prevention & control
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-009-1164-8

The aim of the study was to ascertain the validity of a personal protocol used for the diagnostic classification of a group of 20 patients suffering from migraine without aura and with recurrent vertigo and postural disorders. A series of ten factors (anamnestic and constitutional) considered predictive of migrainous vertigo and four types of response to sensory provocation made it possible to identify two types of patients: type A, simultaneous presence of at least 5 (≥50%) of the 10 factors considered and at least 2 (≥50%) of the four established responses; type B, presence of fewer than five factors (≤50%), or of more than five (≥50%) but fewer than two (≤50%) of the responses envisaged by the protocol. All patients underwent migraine prophylaxis for 4 months. Vertigo and postural status were evaluated using a questionnaire, i.e. the Dizziness Handicap Inventory (DHI), and a posturographic test before and after prophylaxis. The treatment was considered effective by 30% of the total group of 20 patients and by 75% of type A patients. No improvement was recorded in type B patients. Furthermore, the latter group did not show significant changes in the DHI or posturographic tests. Instead, type A patients demonstrated a statistically significant reduction in sway area and DHI score at the end of prophylaxis ( P  = 0.001). Research into a particular constitutional functional habitus, thus, proved useful for the diagnostic definition of migraine-associated vertigo.