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. 2021 Mar 1;42(3):461-465.
doi: 10.1097/MAO.0000000000002976.

Migraine Features in Patients With Recurrent Benign Paroxysmal Positional Vertigo

David Bruss  1 , Mehdi Abouzari  1 , Brooke Sarna  1 , Khodayar Goshtasbi  1 , Ariel Lee  1 , Jack Birkenbeuel  1 , Hamid R Djalilian  1   2
Affiliations

Migraine Features in Patients With Recurrent Benign Paroxysmal Positional Vertigo

David Bruss et al. Otol Neurotol. .

Abstract

Objectives: To identify migraine features present in a cohort of patients with recurrent benign paroxysmal positional vertigo (BPPV).

Methods: Patients presenting with recurrent BPPV were surveyed. Recurrent BPPV was defined as three episodes or greater in 6 months before presentation, with resolution of symptoms after Epley maneuver. Current or past migraine headache (MH) diagnosis was made according to the International Headache Society guidelines.

Results: Fifty-eight patients with recurrent BPPV with a mean age of 53.8 ± 17.4 years were included. Half (29 patients) fulfilled criteria for MH and half (29 patients) did not meet the criteria for MH (non-MH). No statistically significant difference was found in a majority of migraine-related symptoms between the MH and non-MH cohorts with recurrent BPPV. History of migraine medication usage (p = 0.008), presence of a weekly headache (p = 0.01), and duration of dizziness after positional vertigo (p = 0.01) were the only variables that were different on multivariate analysis between the MH and non-MH cohorts.

Conclusions: Half of recurrent BPPV patients suffer from migraine headaches. The other half presented with migraine-related symptoms, but do not meet criteria for MH. The high comorbidity of MH in our recurrent BPPV cohort as well as the absence of a statistically significant difference in a majority of migraine-related features among patients who did and did not fulfill criteria for MH may suggest that recurrent BPPV has a relationship with migraine. Recurrent BPPV may potentially be a manifestation of migraine in the inner ear, which we term otologic migraine including cochlear, vestibular, or cochleovestibular symptoms.

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Conflict of interest statement

Conflicts of Interest: None.

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