Relationship between basilar-type migraine and migrainous vertigo

Objective: This study compared clinical manifestations and audiovestibular function tests among subjects of basilar-type migraine (BtM), definite and probable migrainous vertigo (dMV and pMV), in order to investigate the relationship between them. Background: Various diagnostic criteria such as BtM, dMV, and pMV have been proposed. However, a comparison between these diagnostic groups has not been conducted before. Methods: This study enrolled 77 subjects, including BtM in 15, dMV in 30, and pMV in 32 patients. All patients received structured interview of clinical presentations and underwent a battery of audiovestibular function tests. Results: Demographic features were similar between 3 groups, including age, gender, precipitating factors, and family preponderance. When considering the clinical manifestations, for example motion sickness, migrainous symptoms, and sequential relationship between headache and vertigo, BtM and dMV groups shared similar features, but differed from pMV group. As regards to differentiate between BtM and dMV patients, the former revealed higher occurrence rates than the latter in relation to the frequency of vertigo attacks, neurological symptoms, and saccadic dysmetria. Conclusion: The relationship between BtM, dMV, and pMV refers to a distribution of severity across the disease spectrum of migraine-related vertigo. Of them, BtM group presents the most severe form in clinical manifestation and brainstem involvement, followed by dMV, and pMV is the mildest form. © 2008 American Headache Society.