Teggi R, et al. - In a sample of 252 subjects with a diagnosis of definite vestibular migraine, the features of vertiginous episodes, accompanying symptoms, familial history, and migraine precursors were assessed using a questionnaire. Findings indicated that in pediatric patients, vestibular symptoms may act as a predisposing factor to develop vestibular migraine at an earlier age in adulthood.

Methods

• Two hundred and fifty-two subjects were recruited from different centers in this cross-sectional study.
• A senior specialist assessed features of vestibular symptoms and accompanying symptoms through a structured questionnaire.

Results

• For migraine and vertigo, the age of onset was 23 years and 38 years, respectively.
• Internal vertigo was reported by 184 subjects (73%), while 63 subjects (25%) reported external vertigo.
• The duration of vertigo attacks was less than 5 minutes in 58 subjects (23%), between 6 and 60 minutes in 55 (21.8%), between 1 and 4 hours in 29 (11.5%), 5 and 24 hours in 44 (17.5%), up to 3 days in 14 (5.5%), and more than 3 days in seven (2.8%); 14 subjects (5.5%) stated attacks lasted from less than 5 minutes and up to 1 hour, 9 (3.6%) stated attacks lasted from less than 5 minutes and up to 1 to 4 hours, 6 (2.4%) stated attacks lasted from less than 5 minutes to up to 5 to 24 hours, and 5 (2%) stated attacks lasted from less than 5 minutes up to days.
• Patients reported the following accompanying symptoms: nausea (59.9%), photophobia (44.4%), phonophobia (38.9%), vomiting (17.8%), palpitations (11.5%), tinnitus (10.7%), fullness of the ear (8.7%), and hearing loss (4%).
• A positive family history of migraine was noted in 177 subjects (70.2%), while a positive family history of vertigo was noted in 167 subjects (66.3%).
• At least one of the pediatric precursors was reported by 69% of patients, specifically, 42.8% of subjects mentioned motion sickness.
• In the sub-sample with a familial history of migraine, the age of onset for the first headache was lower than in the total sample.
• A lower age of onset of vertigo in adulthood could be predicted by the pediatric precursors benign paroxysmal vertigo (BPV), benign paroxysmal torticollis, and motion sickness; cyclic vomiting was predictive for vomiting during vertigo attacks in adults.